Bieneman, Bruce K
Bieneman, Bruce K is an individual health care provider with primary practice located at 10010 Kennerly Rd , Saint Louis MO 63128-2106. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Bieneman, Bruce K can be contacted via phone (314) 525-4492.Contact Information
Primary practice address
10010 Kennerly Rd
Saint Louis MO 63128-2106
Phone: (314) 525-4492
Fax: (314) 525-4481
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 108877 | Missouri |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036101977 | Illinois |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD-33964 | Iowa |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 04-28930 | Kansas |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD459547 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 108877 | Missouri |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 108877 | Missouri |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 35173 | Tennessee |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 0101240919 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 21052 | West Virginia |
Profile Details
| NPI number | 1740200187 |
|---|---|
| LBN Legal business name | Bieneman, Bruce K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Oct 29th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740200187 | NPPES |
| Illinois | MEDICAID | 366644640 | |
| Illinois | MEDICAID | 203935416 |
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