Healthcare Provider Details
I. General information
NPI: 1821060278
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: 02/01/2006
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
- Phone: 314-423-8811
- Fax: 314-423-8824
- Phone: 314-423-8811
- Fax: 314-423-8824
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 2000161055 |
| License Number State | MO |
VIII. Authorized Official
Name:
STEPHEN
THOMAS
SEHY
Title or Position: OWNER
Credential: DPM
Phone: 314-423-8811