Provider Demographics
NPI:1831318005
Name:FELDMAN, STEPHEN JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAY
Last Name:FELDMAN
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 1:1099 MILWAUKEE ST
Mailing Address - Street 2:SUITE 30
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-7356
Mailing Address - Country:US
Mailing Address - Phone:314-725-2640
Mailing Address - Fax:314-966-0233
Practice Address - Street 1:1099 MILWAUKEE ST
Practice Address - Street 2:SUITE 30
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-7356
Practice Address - Country:US
Practice Address - Phone:314-725-2640
Practice Address - Fax:314-966-0233
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE006144111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO9112A1OtherANTHEM BCBS
MOU43957OtherMERCY
MO43168237701OtherCMR
MO238547OtherHEALTHLINK
MO4483452OtherUNITED HEALTH CARE
MO5176OtherBLUECHOICE
MO5176OtherBLUECHOICE