Provider Demographics
NPI:1356477996
Name:BERNSTEIN, ROBERT C (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10481 SAINT CHARLES ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074-1836
Mailing Address - Country:US
Mailing Address - Phone:314-423-3344
Mailing Address - Fax:314-423-8934
Practice Address - Street 1:10481 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:SAINT ANN
Practice Address - State:MO
Practice Address - Zip Code:63074-1836
Practice Address - Country:US
Practice Address - Phone:314-423-3344
Practice Address - Fax:314-423-8934
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
87726OtherUNITED HEALTHCARE
14630OtherANTHEM BLUE CROSS