Individual
BENJAMIN DOUGLAS STIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(636) 386-9224
(636) 386-7679
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 386-7679
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2019023484
MO
207L00000X
Anesthesiology Physician
Primary
2021014633
MO
Other
Enumeration date
06/26/2019
Last updated
10/30/2025
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