Provider Demographics
NPI:1457482259
Name:STOJEBA, TODD J (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:J
Last Name:STOJEBA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9979 WINGHAVEN BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-3628
Mailing Address - Country:US
Mailing Address - Phone:314-741-8386
Mailing Address - Fax:
Practice Address - Street 1:11704 BELLEFONTAINE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1741
Practice Address - Country:US
Practice Address - Phone:314-741-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000032030Medicare ID - Type Unspecified
MOU05436Medicare UPIN