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General NPI Number Information
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NPI Number | 1124165428
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Entity Type | Individual
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Provider Name | JULIE ELIZABETH STEWART DPM
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 300 WINDING WOODS DR SUITE214
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City | O FALLON
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State | MO
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Zip | 63366-4771
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Country | US
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Telephone | 636-281-1705
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Fax |
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Provider Business Mailing Address
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Address Line | 12672 MATEUS DR APT. D
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City | SAINT LOUIS
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State | MO
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Zip | 63146-2349
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Country | US
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Telephone | 314-485-1225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2006033772
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License Number State | MO
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