Individual
BRUCE J HOOKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12105 BRIDGETON SQUARE DRIVE, BRIDGETON, MO 63044-2616
(314) 291-2588
(314) 291-4104
Mailing address
12105 BRIDGETON SQUARE DRIVE, BRIDGETON, MO 63044-2616
(314) 291-2588
(314) 291-4104
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
31696
MO
207ND0900X
Dermatopathology Physician
31696
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100861
HEALTHLINK
—
05
—
202820213
—
MO
01
—
20867
BCBS OF MO
—
01
—
72155018
RAILROAD MEDICARE PALMETT
—
01
—
96698
UNITED HEALTHCARE
—
01
—
CS4712
RAILROAD MEDICARE PALMETT
—
Enumeration date
11/27/2006
Last updated
05/28/2008
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