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NPI Code Detail

MEDICARE: JUSTIN STEWART EHRHARDT MD

MEDICARE: JUSTIN STEWART EHRHARDT MD
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
12084P0800XPsychiatry Physician2019018909MO

General Provider Information

NPI Number : 1235798034
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN STEWART EHRHARDT MD
Provider Business Mailing Address
First Line : 1 HOSPITAL DR
Second Line :
City : COLUMBIA
State : MO
Zip : 65212-1000
Country : US
Telephone Number : 573-882-8907
Fax Number : 573-884-1070
Provider Business Practice Location Address
First Line : 600 E 5TH ST
Second Line :
City : FULTON
State : MO
Zip : 65251-1793
Country : US
Telephone Number : 573-592-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2019
Last Update Date : 06/29/2023

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