Provider Demographics
NPI:1609826890
Name:MEDLER, ROBERT G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:MEDLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:12639 OLD TESSON RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2786
Practice Address - Country:US
Practice Address - Phone:314-849-0311
Practice Address - Fax:314-849-4423
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-07-17
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Provider Licenses
StateLicense IDTaxonomies
MO103318207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208615500Medicaid
MO5840245OtherAETNA
MO100045OtherBLUE CROSS BLUE SHIELD
MO52093OtherGROUP HEALTH PLAN
MO290278OtherHEALTHLINK
MO0900509OtherUNITED HEALTHCARE
MO200023667OtherRAILROAD MEDICARE
MO7442012001OtherCIGNA