Provider Demographics
NPI:1477520823
Name:BALE, ROBERT DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DONALD
Last Name:BALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1034 CABERNET DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8307
Mailing Address - Country:US
Mailing Address - Phone:314-394-4661
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 4005
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-5016
Practice Address - Fax:314-567-1846
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO35248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0700143OtherUNITED HEALTHCARE
MO119085OtherHEALTHLINK
MO200004711Medicaid
MO3118423OtherCIGNA
MO3953OtherHEALTHCARE USA
MO4542OtherBLUE SHIELD
MO100073OtherMERCY HEALTH PLAN
MO400050OtherAETNA
MO1408OtherGROUP HEALTH PLAN
MO92513OtherFIRST HEALTH
MO0700143OtherUNITED HEALTHCARE
MO4542OtherBLUE SHIELD
MOA10089Medicare UPIN