Individual
DR. MICHAEL D. BAZZANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1165
(314) 525-1485
Mailing address
11475 OLDE CABIN RD STE 200, SAINT LOUIS, MO 63141-7129
(314) 991-8200
(314) 569-1787
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2020011605
MO
2085R0202X
Diagnostic Radiology Physician
MO00044498
TN
Other
Enumeration date
05/30/2007
Last updated
09/07/2022
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