Provider Demographics
NPI:1093703290
Name:YOSELEVSKY, ROBERT STEVEN (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEVEN
Last Name:YOSELEVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:STE 5006B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-432-1254
Mailing Address - Fax:314-569-0864
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:STE 5006B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-432-5478
Practice Address - Fax:314-569-0864
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR6187207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200921807Medicaid
MO101480OtherHEALTHLINK
MO4002OtherBCBS
MO4002OtherBCBS
A11531Medicare UPIN