MEDICARE: DR. JOHN GRAHAM STEUTERMAN JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12548	MO

General Provider Information

NPI Number	:	1033106810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN GRAHAM STEUTERMAN JR.

Provider Business Mailing Address
First Line	:	777 S NEW BALLAS RD
Second Line	:	SUITE 310-WEST
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8705
Country	:	US
Telephone Number	:	314-569-3660
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 S NEW BALLAS RD
Second Line	:	SUITE 310-WEST
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8705
Country	:	US
Telephone Number	:	314-569-3660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	07/08/2007

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