Individual
MONTACER BELFANCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 584-4803
Mailing address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 584-4803
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
2014004753
MO
363L00000X
Nurse Practitioner
Primary
2024030419
MO
Other
Enumeration date
07/01/2024
Last updated
09/19/2025
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