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Contact Information

BRUCE K BIENEMAN, MD
10010 KENNERLY RD
SAINT LOUIS, MO63128-2106
 Phone: 314-525-4492
 Fax: 314-525-4481
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Neuroradiology

2085N0700X
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for BRUCE K BIENEMAN · (Male)

NPI Number 1740200187
Status Active
Credentials MD
Entity Individual
Enumeration date 07/20/2006
Last updated 10/29/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IA License # MD-33964
  • IL License # 036101977
  • KS License # 04-28930
  • MO License # 108877
  • PA License # MD459547
  • TN License # 35173
  • VA License # 0101240919
  • WV License # 21052
  • IL Medicaid 366644640
  • MO Medicaid 203935416
Hospital affiliation(s)
  • BAPTIST MEMORIAL HOSPITAL UNION CITY - (Acute Care)
    1201 BISHOP ST, PO BOX 310
    UNION CITY, TN 38261
  • DYERSBURG REGIONAL MEDICAL CENTER - (Acute Care)
    400 TICKLE ST
    DYERSBURG, TN 38024
  • HENRY COUNTY MEDICAL CENTER - (Acute Care)
    301 TYSON AV
    PARIS, TN 38242
  • PHELPS COUNTY REGIONAL MEDICAL CENTER - (Acute Care)
    1000 W 10TH ST
    ROLLA, MO 65401
  • ST ANTHONY'S MEDICAL CENTER - (Acute Care)
    10010 KENNERLY ROAD
    SAINT LOUIS, MO 63128
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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