MEDICARE: MR. ROBERT E ANTHONY MSW

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	1041C0700X	Clinical Social Worker	002313	MO

General Provider Information

NPI Number	:	1366466229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT E ANTHONY MSW

Provider Business Mailing Address
First Line	:	6220 S LINDBERGH BLVD STE 201
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7839
Country	:	US
Telephone Number	:	314-780-2132
Fax Number	:	314-894-2942

Provider Business Practice Location Address
First Line	:	6220 S LINDBERGH BLVD STE 201
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-7839
Country	:	US
Telephone Number	:	314-780-2132
Fax Number	:	314-894-2942

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	01/05/2018

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