Healthcare Provider Details

I. General information

NPI: 1689619280
Provider Name (Legal Business Name): SPECIALISTS IN ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3933 S BROADWAY ANESTHESIA DEPT
ST LOUIS MO
63118
US

IV. Provider business mailing address

PO BOX 191034
ST LOUIS MO
63119-1034
US

V. Phone/Fax

Practice location:
  • Phone: 314-865-7992
  • Fax:
Mailing address:
  • Phone: 314-453-0600
  • Fax: 314-453-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRAD BERNSTEIN
Title or Position: SOLE OWNER PRESIDENT
Credential: MD
Phone: 314-625-2950