Individual
DR. BRUCE JAY BERWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3478 BRIDGELAND DR, BRIDGETON, MO 63044-2619
(314) 739-8200
(314) 739-8261
Mailing address
3478 BRIDGELAND DR, BRIDGETON, MO 63044-2639
(314) 739-8200
(314) 735-4490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
114332
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205292204
—
MO
Enumeration date
09/08/2006
Last updated
01/15/2019
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