MEDICARE: ROBERT L BYNUM DO

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	207Q00000X	Family Medicine Physician	36421	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	100463	OTHER	MO	BLUE CHOICE
4	100463	OTHER	MO	BLUE SHIELD
5	130835	OTHER	MO	HEALTHLINK
6	104036	OTHER	MO	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1952348690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT L BYNUM DO

Provider Business Mailing Address
First Line	:	1906 POTOMAC DR
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-5843
Country	:	US
Telephone Number	:	573-443-0075
Fax Number	:	573-445-8080

Provider Business Practice Location Address
First Line	:	201 W BROADWAY STE B
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-3842
Country	:	US
Telephone Number	:	573-443-0075
Fax Number	:

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	11/01/2025

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Directions to “ ROBERT L BYNUM DO” Practice Location

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