Bruce J Walz, MD | |
3635 Vista, St Louis, MO 63110 | |
(314) 577-8815 | |
(314) 268-5106 |
Full Name | Bruce J Walz |
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Gender | Male |
Speciality | Radiology - Radiation Oncology |
Location | 3635 Vista, St Louis, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063439677 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0001X | Radiology - Radiation Oncology | 30961 (Missouri) | Primary |
Entity Name | Southeast Missouri Hospital Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558311522 PECOS PAC ID: 9133024334 Enrollment ID: O20031201000775 |
Mailing Address | Practice Location Address |
---|---|
Bruce J Walz, MD 3691 Rutger Ave, Provider Enrollment, St Louis, MO 63110 Ph: (314) 977-4440 | Bruce J Walz, MD 3635 Vista, St Louis, MO 63110 Ph: (314) 577-8815 |
John A Merkle, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 774 N New Ballas Rd, St Louis, MO 63141 Phone: 314-567-1656 Fax: 314-567-0622 | |
Humberto M Fagundes, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3015 N New Ballas Rd, St Louis, MO 63131 Phone: 314-996-5180 Fax: 314-821-2180 | |
Jenny Lynne Shaffer, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 10010 Kennerly Road, Attn Cancer Care Center, St Louis, MO 63128 Phone: 314-525-1688 Fax: 314-525-1689 | |
John H Niemeyer, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3015 N New Ballas Rd, St Louis, MO 63131 Phone: 314-996-5180 Fax: 314-821-2180 | |
Ustun Aydingoz, MD Radiology Medicare: Medicare Enrolled Practice Location: 3635 Vista, St Louis, MO 63110 Phone: 314-268-5783 Fax: 314-268-5116 | |
Amy A Mosher, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3015 N New Ballas Rd, St Louis, MO 63131 Phone: 314-966-5180 Fax: 314-821-2180 |