Provider Demographics
NPI:1710980875
Name:BERNI, ANTHONY J (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:BERNI
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 1:9323 PHOENIX VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-4281
Mailing Address - Country:US
Mailing Address - Phone:636-561-0871
Mailing Address - Fax:
Practice Address - Street 1:9323 PHOENIX VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-4281
Practice Address - Country:US
Practice Address - Phone:636-561-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO103624207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO115065OtherBLUE CROSS BLUE SHIELD
SP17697OtherCIGNA
384663OtherHEALTHLINK
30186V3458OtherGHP/ADVANTRA
901011OtherUHC
9221OtherEXCLUSIVE CHOICE
6091V6097OtherHEALTHCARE USA
384663OtherHEALTHLINK
57184OtherCMR
SP17697OtherCIGNA
30186V3458OtherGHP/ADVANTRA
351240001OtherCIGNA DMERC
5061639OtherAETNA