BRUCE J WALZ (NPI# 1063439677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063439677 |
| Entity Type | Individual |
| Full Name | BRUCE J WALZ |
| Credential | MD |
| Practice Address |
3635 Vista St Louis MO 63110 |
| Mailing Address |
3691 Rutger Ave Provider Enrollment St Louis MO 63110 |
| Practice Telephone | 3145778815 |
| Practice Fax Number | 3142685106 |
| Mailing Telephone | 3149774440 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
30961 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
3635 VISTA |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194829705 | Donald L Kaminski | Surgery | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-12 |
| 1598869109 | William F Sasser | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-12 |
| 1003910225 | Eddy C Hsueh | Surgery | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-08 |
| 1629172846 | Carl Freeman | Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-09-08 |
| 1457455677 | Richard D. Bucholz | Neurological Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-09-08 |
| 1356445571 | Bruce A Kraemer | Surgery | 3635 Vista, 3rd Floor, St Louis, MO 63110 | 2006-09-08 |
| 1073617296 | Ralph J Graff | Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-09-08 |
| 1932202363 | Keith S Naunheim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3635 Vista, 3rd Floor Department of Surgery, St Louis, MO 63110 | 2006-09-07 |
| 1972614626 | Saleem I Abdulrauf | Neurological Surgery | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-08-31 |
| 1639288236 | Robert M Maloney | Urology | 3635 Vista, 3rd Fl, St Louis, MO 63110 | 2006-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073838322 | Jenny Lynne Shaffer | Radiology | 10010 Kennerly Road, Attn Cancer Care Center, St Louis, MO 63128-2106 | 2010-03-30 |
| 1033227806 | Humberto M Fagundes | Radiology | 3015 N New Ballas Rd, St Louis, MO 63131 | 2006-08-29 |
| 1316967722 | Macdonald B Logie | Radiology | 3635 Vista, St Louis, MO 63110 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778228 | Central Care, Pa | Radiology | 1004 Carondelet Dr Ste 410, Kansas City, MO 64114-4801 | 2020-10-23 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1518229772 | Andrew L Walker | Radiology | 902 N Riverside Rd Ste 201, Saint Joseph, MO 64507 | 2012-06-13 |
| 1568721454 | Jason Matthew Edwards | Radiology | 232 S Woods Mill Rd Ste 110e, Chesterfield, MO 63017 | 2012-05-11 |
| 1649569385 | Sagar Chandravadan Patel | Radiology | 211 Saint Francis Dr Ste 372, Cape Girardeau, MO 63703-5049 | 2011-04-04 |
| 1922326958 | Yvonne Thanh-nga D Pham | Radiology | 6601 Winchester Ave Ste 230, Kansas City, MO 64133-4681 | 2010-05-14 |
| 1811158587 | Benjamin Bin Yan | Radiology | 1111 Kentucky Ave., Omc Cancer Treatment Center, West Plains, MO 65775-2028 | 2008-06-24 |
| 1336338912 | Joseph Fields | Radiology | 9 Heather Hill Ln, Saint Louis, MO 63132-4105 | 2007-10-18 |
| 1205033941 | Associates In Tumor Therapy, Chartered | Radiology | 2801 Clearwater Ct, Joplin, MO 64801-8239 | 2007-06-27 |
| 1700916848 | Bethesda Resources Inc | Radiology | 1124 N Main St, Sikeston, MO 63801-5046 | 2007-03-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.