Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 103680 | MO |
Y | 207R00000X | Internist | 103680 | MO |
Y | 111NI0900X | Internist | 103680 | MO |
NPI | 1164483350 |
---|---|
Provider Name | Dr. Maureen E Stoffa |
First Address | Saint Louis, MO 63131-2322 |
Second Address | Saint Louis, MO 63131-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 08/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208802900 | (05) | MO |
G29060 | (02) | MO |