Provider Demographics
NPI:1801051255
Name:WEST, ROBERT M (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:WEST
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:15510 OLIVE BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-0170
Mailing Address - Country:US
Mailing Address - Phone:314-720-0050
Mailing Address - Fax:314-787-2133
Practice Address - Street 1:15510 OLIVE BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-0170
Practice Address - Country:US
Practice Address - Phone:314-720-0050
Practice Address - Fax:314-787-2133
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2015-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.009978208C00000X
MO2014010407208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1801051255Medicaid
OH3133273Medicaid
OH3133273Medicaid