Provider Demographics
NPI:1841281193
Name:ADAMS, WILLIAM STUART (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STUART
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:636-561-5291
Mailing Address - Fax:636-561-5290
Practice Address - Street 1:9979 WINGHAVEN BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-3627
Practice Address - Country:US
Practice Address - Phone:636-561-5291
Practice Address - Fax:636-561-5290
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO100451208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO172500OtherHEALTHLINK
MO431383893ADAOtherMERCY MC PL
MO4226209OtherAETNA
MO39933OtherGHP
MO1816V34311OtherHEALTHCARE USA
1200153OtherUHC EPO
MO28224OtherBCBS
MO1201836OtherUHC
MO431383893ADAOtherMERCY