# DR. STUART DAVID FEDERMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1700162567
- **Gender:** Man
- **Credential:** PHARM.D., AAHIVE

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 051292647 | IL | — |
| 183500000X | Pharmacist | 2007023343 | MO | Yes |

## Other

- **Enumeration date:** 10/25/2011
- **Last updated:** 10/25/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 600201206 | — | MO |