MEDICARE: S THOMAS SEHY D P M L L C

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	213E00000X	Podiatrist

Other Identifiers

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

General Provider Information

NPI Number	:	1689145898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S THOMAS SEHY D P M L L C

Provider Business Mailing Address
First Line	:	10430 PAGE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-1228
Country	:	US
Telephone Number	:	314-423-8811
Fax Number	:	314-423-8824

Provider Business Practice Location Address
First Line	:	213 NW 10TH ST STE B
Second Line	:
City	:	FAIRFIELD
State	:	IL
Zip	:	62837-1219
Country	:	US
Telephone Number	:	618-842-2522
Fax Number	:	618-842-2523

Authorized Official
Title or Position	:	OWNER/ PODIATRIST
Name	:	STEPHEN THOMAS SEHY
Credential	:	DPM
Telephone Number	:	314-423-8811

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	12/16/2018

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