Individual
STACY GITTEL BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1060 MEYER RD, WENTZVILLE, MO 63385-3800
(314) 230-1500
(314) 230-1122
Mailing address
1060 MEYER RD, WENTZVILLE, MO 63385-3800
(314) 230-1500
(314) 230-1122
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2020010791
MO
Other
Enumeration date
05/08/2016
Last updated
08/28/2024
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