Jeffrey S Boberg Dpm LLC
Podiatrist, Foot & Ankle Surgery in Bridgeton, MO. Organization (NPI-2).
NPI number1639280290
StatusActive
Last updated in NPPESNov 23, 2009
Details
- NPI
- 1639280290
- Entity type
- Organization (NPI-2)
- Legal business name
- Jeffrey S Boberg Dpm LLC
- Organization subpart
- No
- Enumeration date
- Aug 31, 2006
- Last updated
- Nov 23, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 000570 | MO | Yes |
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 016005217 | IL | |
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 2003013610 | MO | |
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 016005131 | IL | |
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 016004233 | IL | |
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 2005026457 | MO |
Other names
- Ankle & Foot Surgeons Of The Midwest (Doing Business As)
Practice location
12255 De Paul DrSte 100
Bridgeton, MO 63044-2510
Phone 314-739-7100 · Fax 314-739-3199
Mailing address
12255 De Paul DrSte 100
Bridgeton, MO 63044-2510
Phone 314-739-7100 · Fax 314-739-3199
Authorized official
Jeffrey S Boberg
President/Physician
3147397100
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