Provider Demographics
NPI:1285936708
Name:BEZREH, ANTHONY ANDREW (ANTHONY BEZREH MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ANDREW
Last Name:BEZREH
Suffix:
Gender:M
Credentials:ANTHONY BEZREH MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SUMMERHILL LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8408
Mailing Address - Country:US
Mailing Address - Phone:314-469-0341
Mailing Address - Fax:
Practice Address - Street 1:8 SUMMERHILL LN
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-8408
Practice Address - Country:US
Practice Address - Phone:314-469-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5H512083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine