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Individual

STEPHEN LARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
Mailing address
PO BOX 4853, OAK BROOK, IL 60522-4853
(314) 344-6000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2003010856
MO
207P00000X
Emergency Medicine Physician
Primary
36000
SC

Other

Enumeration date
08/31/2006
Last updated
02/23/2026
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