Individual
BRUCE MATATHIAS BASKIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3165 MCKELVEY RD STE 100, BRIDGETON, MO 63044
(314) 739-1333
(314) 739-1350
Mailing address
3165 MCKELVEY RD STE 100, BRIDGETON, MO 63044-2550
(314) 739-1333
(314) 739-1350
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
R6G51
MO
207R00000X
Internal Medicine Physician
Primary
R6G51
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207930934
—
MO
Enumeration date
08/23/2006
Last updated
12/11/2025
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