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Contact Information

BIJAN BASTANINEJAD, MD
2620 N WESTWOOD BLVD
POPLAR BLUFF, MO63901-3396
 Phone: 573-785-7721
 Fax: 573-727-2465
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Hospitalist

208M00000X
Indicates primary specialty

NPI Profile & details for BIJAN BASTANINEJAD · (Male)

NPI Number 1972589968
Status Active
Credentials MD
Entity Individual
Enumeration date 12/21/2005
Last updated 11/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2009039681
  • NY License # 237324
  • OH License # 35.088489
  • MI Medicaid 4920459
  • MI Medicaid 5202199
  • NY Medicaid 02695054
  • OH Medicaid 2678446
  • MI Other 40113 HPM
  • NY Other 237324 BLUECROSS BLUESHIELD
  • OH Other 7210867 AETNA
  • OH Other 000000488786 ANTHEM
  • OH Other 000000520832 ANTHEM
  • OH Other 05227 PARAMOUNT
Hospital affiliation(s) Not Available
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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