Doctor Name: | MEREDITH B STUART |
NPI Number: | 1043292840 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPM |
License Number: | 9410M1973 |
Business Practice Address: | 16087 Manchester Rd Ellisville, MO - 630112103 |
Business Phone Number: | 6362303883 |
Business Fax Number: | 6362303884 |
Mailing Address: | 16087 Manchester Rd, ELLISVILLE |
State: | MO |
Postal Code: | 630112103 |
Phone Number: | 6362303883 |
Fax Number: | 6362303884 |
NPI Enumeration Date: | 11/17/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | 9410M1973 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |