Healthcare Provider Details

I. General information

NPI: 1619448453
Provider Name (Legal Business Name): S THOMAS SEHY D P M L L C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 CHIPPEWA ST STE 316
SAINT LOUIS MO
63109-2532
US

IV. Provider business mailing address

10430 PAGE AVE
SAINT LOUIS MO
63132-1228
US

V. Phone/Fax

Practice location:
  • Phone: 877-248-3668
  • Fax: 314-423-8824
Mailing address:
  • Phone: 314-423-8811
  • Fax: 314-423-8824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: ANGELA TERESE MILLSTONE
Title or Position: BILLING MANAGER
Credential:
Phone: 314-423-8811