Provider Demographics
NPI:1518948900
Name:POZZI, ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:POZZI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-647-9444
Mailing Address - Fax:314-647-7317
Practice Address - Street 1:1031 BELLEVUE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1818
Practice Address - Country:US
Practice Address - Phone:314-644-9444
Practice Address - Fax:314-647-7317
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100228207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS171337OtherHEALTHLINK
MOF23220OtherMERCY
MS0100146OtherUHC
MS111780OtherBCBS
MO2161761OtherAETNA US
MO000000010048OtherESSENCE
MO4233615OtherAETNA
MO40383OtherGHP
MO243616513Medicaid
MO4233615OtherAETNA
MO000000010048OtherESSENCE
MO40383OtherGHP