Healthcare Provider Details

I. General information

NPI: 1326040981
Provider Name (Legal Business Name): STEPHEN THOMAS SEHY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10430 PAGE AVE
SAINT LOUIS MO
63132-1228
US

IV. Provider business mailing address

10430 PAGE AVE
SAINT LOUIS MO
63132-1228
US

V. Phone/Fax

Practice location:
  • Phone: 314-423-8811
  • Fax: 314-423-8824
Mailing address:
  • Phone: 314-423-8811
  • Fax: 314-423-8824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016005192
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2000161055
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: