Provider Demographics
NPI:1386732196
Name:BIESER, ROBERT D (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:BIESER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2907 KEYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-1724
Mailing Address - Country:US
Mailing Address - Phone:573-803-2400
Mailing Address - Fax:877-516-6401
Practice Address - Street 1:2907 KEYSTONE DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-1724
Practice Address - Country:US
Practice Address - Phone:573-803-2400
Practice Address - Fax:877-516-6401
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO104929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO246850705Medicaid
MOF54582Medicare UPIN
MO246850705Medicaid