Provider Demographics
NPI:1114929254
Name:BOBROW, JAMES CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CHARLES
Last Name:BOBROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:121 HUNTER AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2000
Mailing Address - Country:US
Mailing Address - Phone:314-721-1140
Mailing Address - Fax:314-721-1863
Practice Address - Street 1:121 HUNTER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63124-2000
Practice Address - Country:US
Practice Address - Phone:314-721-1140
Practice Address - Fax:314-721-1863
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2019-12-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR5491207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA10982Medicare UPIN
MO0703660001Medicare NSC
MO002009024Medicare PIN