Bromberg, Burt I.

Bromberg, Burt I. is an individual health care provider with primary practice located at 621 S New Ballas Rd Suite 198-A, Saint Louis MO 63141-8232. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Bromberg, Burt I. can be contacted via phone (314) 251-6777.

Contact Information

Primary practice address
621 S New Ballas Rd Suite 198-A Saint Louis MO 63141-8232
Phone: (314) 251-6777
Fax: (314) 251-5859
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X R9H67 Missouri
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X MD2020-0088 New Mexico

Profile Details

NPI number 1124135454
LBN Legal business name Bromberg, Burt I.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Feb 27th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124135454 NPPES
Missouri MEDICAID 202593737

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