Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 015113 | MO |
Y | 213EG0000X | General Practice | 015113 | MO |
NPI | 1003898594 |
---|---|
Provider Name | Dr. Ronald James Sherstoff |
First Address | Chesterfield, MO 63017-1843 |
Second Address | Chesterfield, MO 63017-1843 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |