Provider Demographics
NPI:1518969963
Name:SCHLAFLY, BRUCE (MD)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:SCHLAFLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10004 KENNERLY RD
Mailing Address - Street 2:SUITE 259-B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2141
Mailing Address - Country:US
Mailing Address - Phone:314-842-2200
Mailing Address - Fax:314-842-4385
Practice Address - Street 1:10004 KENNERLY RD
Practice Address - Street 2:SUITE 259-B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2141
Practice Address - Country:US
Practice Address - Phone:314-842-2200
Practice Address - Fax:314-842-4385
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR3F82207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO102020OtherHEALTHLINK
MO208595009Medicaid
MO26373OtherBC/BS
MO000002497Medicare ID - Type Unspecified
A10339Medicare UPIN