Organization
BERWALD SURGICAL MEDICAL INC
Active
Other names
DAVID BERWALD MD
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE BERWALD MD (OWNER)
(314) 739-8200
Entity
Organization
Contact information
Practice address
3478 BRIDGELAND DR, STE 2, BRIDGETON, MO 63044-2619
(314) 739-8200
(314) 739-8261
Mailing address
3478 BRIDGELAND DR, STE 2, BRIDGETON, MO 63044-2619
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
114322
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635653
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/26/2006
Last updated
08/22/2020
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