Individual
ROGER G. CERNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
11133 DUNN ROAD, ST LOUIS, MO 63136-6119
(314) 923-4640
Mailing address
PO BOX 22407, SAINT LOUIS, MO 63126-0407
(636) 386-7222
(636) 386-7810
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
065267
MO
367500000X
Certified Registered Nurse Anesthetist
209000686
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918913807
—
MO
01
—
P00415481
RR MEDICARE
—
Enumeration date
01/16/2006
Last updated
09/24/2008
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