Provider Demographics
NPI:1326040981
Name:SEHY, STEPHEN THOMAS (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:SEHY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10430 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-1228
Mailing Address - Country:US
Mailing Address - Phone:314-423-8811
Mailing Address - Fax:314-423-8824
Practice Address - Street 1:10430 PAGE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-1228
Practice Address - Country:US
Practice Address - Phone:314-423-8811
Practice Address - Fax:314-423-8824
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005192213E00000X
MO2000161055213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO305705824Medicaid
ILK11260Medicare ID - Type Unspecified
MO305705824Medicaid
MO000025606Medicare ID - Type Unspecified