MEDICARE: DR. ROBERT S GELLMAN

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	111N00000X	Chiropractor	4226	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6732	OTHER	MO	BLUE CROSS BLUE SHIELD ID

General Provider Information

NPI Number	:	1407851280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT S GELLMAN

Provider Business Mailing Address
First Line	:	2050 CAMPUS DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-1048
Country	:	US
Telephone Number	:	636-724-4010
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 CAMPUS DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-1048
Country	:	US
Telephone Number	:	636-724-4010
Fax Number	:

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/02/2010

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Directions to “ DR. ROBERT S GELLMAN ” Practice Location

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