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Individual

DR. STEPHEN S. WALTHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
456 N. NEW BALLAS RD., SUITE 304, ST. LOUIS, MO 63141
(314) 567-6868
(314) 567-0578
Mailing address
456 N. NEW BALLAS RD., SUITE 304, ST. LOUIS, MO 63141
(314) 567-6868
(314) 567-0578

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2014010845
MO
390200000X
Student in an Organized Health Care Education/Training Program
N/A

Other

Enumeration date
04/01/2011
Last updated
09/11/2014
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