Doctor Name: | DR. STEPHEN S. WALTHER |
NPI Number: | 1912296740 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | N/A |
Business Practice Address: | 456 N. New Ballas Rd. Suite 304 St. Louis, MO - 63141 |
Business Phone Number: | 3145676868 |
Business Fax Number: | 3145670578 |
Mailing Address: | 456 N. New Ballas Rd., Suite 304 ST. LOUIS |
State: | MO |
Postal Code: | 63141 |
Phone Number: | 3145676868 |
Fax Number: | 3145670578 |
NPI Enumeration Date: | 04/01/2011 |
NPI Last Update Date: | 09/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | N/A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |