Individual
ROBERT BYRNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12255 DE PAUL DR, SUITE 700, BRIDGETON, MO 63044-2510
(314) 739-4166
(314) 739-2485
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 739-4166
(314) 739-2485
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R1J78
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010010
ESSENCE
MO
01
—
000000012459
ESSENCE ST CHARLES
MO
01
—
0400915
UHC
MO
01
—
0403000
UHC MEDICARE COMPLETE
—
01
—
11011
BCBS
MO
01
—
127465
GHP
—
01
—
165438
HEALTHLINK
MO
01
—
165438
HEALTHLINK
—
05
—
202580312
—
MO
01
—
5241272
AETNA
MO
01
—
B18388
MERCY
MO
01
—
D04003
EXCLUSIVE CHOICE
MO
Enumeration date
11/08/2005
Last updated
09/21/2012
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