MEDICARE: DR. CHRISTOPHER MICHAEL BIENIEK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	100325	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	002011765	OTHER	MO	MEDICARE PROVIDER NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073513024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MICHAEL BIENIEK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 935
Second Line	:	188 MEDICAL DRIVE
City	:	HANNIBAL
State	:	MO
Zip	:	63401-0935
Country	:	US
Telephone Number	:	573-248-1010
Fax Number	:	573-248-0536

Provider Business Practice Location Address
First Line	:	188 MEDICAL DR
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-6877
Country	:	US
Telephone Number	:	573-248-1010
Fax Number	:	573-248-0536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	09/26/2013

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