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NPI Code Detail

MEDICARE: DR. BRADLEY P STONER MD

MEDICARE: DR. BRADLEY P STONER 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
1207RI0200XInfectious Disease Physician107369MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659334555
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRADLEY P STONER MD
Provider Business Mailing Address
First Line : 1 BROOKINGS DR
Second Line : BOX 1114
City : SAINT LOUIS
State : MO
Zip : 63130-4862
Country : US
Telephone Number : 314-935-5673
Fax Number : 314-935-8535
Provider Business Practice Location Address
First Line : 1 BROOKINGS DR
Second Line : BOX 1114
City : SAINT LOUIS
State : MO
Zip : 63130-4862
Country : US
Telephone Number : 314-935-5673
Fax Number : 314-935-8535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 01/05/2015

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