Provider Demographics
NPI:1548333784
Name:STIRNAMAN, JOHN E (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:STIRNAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE. 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:618-463-7600
Mailing Address - Fax:618-463-7601
Practice Address - Street 1:4 MEMORIAL DRIVE
Practice Address - Street 2:STE 130B
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-4707
Practice Address - Country:US
Practice Address - Phone:618-463-7600
Practice Address - Fax:618-463-7601
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-053362207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0360053362Medicaid
ILCC40044Medicare UPIN
IL616870Medicare ID - Type UnspecifiedMEDICARE NUMBER