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1669499638
STACY BEATY
ST LOUIS, MO
NPI
1669499638
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207N00000X Dermatology
(Licence: MO 2005004429)
Enumeration Date
2006-07-16
Last Update Date
2007-07-08
Business Address
-- STACY BEATY MD
1755 S GRAND
ST LOUIS, MO 63104
Phone number: 314-256-3433
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Mailing Address
-- STACY BEATY MD
3691 RUTGER AVE PROVIDER ENROLLMENT
ST LOUIS, MO 63110
Phone number: 314-977-6828
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