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Individual

JOHN MORRIS BEDWINEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 MEDICAL PLZ STE 100, LAKE ST LOUIS, MO 63367-1493
(636) 695-2316
(636) 639-8676
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
036176269
IL
2085R0001X
Radiation Oncology Physician
Primary
R8484
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107975
BCBS
MO
05
201801628
MO
01
2409021
UHC
01
4119583
AETNA
01
49795
GHP
01
900001981
RR MEDICARE
Enumeration date
04/21/2006
Last updated
04/23/2026
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