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Individual

BRUCE K BIENEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-4492
(314) 525-4481
Mailing address
11475 OLDE CABIN RD STE 200, SAINT LOUIS, MO 63141-7129
(314) 991-8200
(314) 991-8206

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
108877
MO
2085R0202X
Diagnostic Radiology Physician
0101240919
VA
2085R0202X
Diagnostic Radiology Physician
036101977
IL
2085R0202X
Diagnostic Radiology Physician
04-28930
KS
2085R0202X
Diagnostic Radiology Physician
Primary
108877
MO
2085R0202X
Diagnostic Radiology Physician
21052
WV
2085R0202X
Diagnostic Radiology Physician
35173
TN
2085R0202X
Diagnostic Radiology Physician
MD-33964
IA
2085R0202X
Diagnostic Radiology Physician
MD459547
PA
2085R0204X
Vascular & Interventional Radiology Physician
108877
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203935416
MO
05
366644640
IL
Enumeration date
07/20/2006
Last updated
10/29/2020
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