NPI 1093366064 · live from the CMS NPI Registry
Richard Bonsra Fynn, MD,DPM
Podiatrist, Foot & Ankle Surgery in Bridgeton, MO. National Provider Identifier 1093366064, active.
NPI record
| NPI | 1093366064 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 12303 Depaul Drive, Bridgeton, MO 63044 |
| Practice phone | 636-734-5835 |
| Mailing address | 285 Boston Dr, North Salt Lake, UT 84054 |
| Enumerated | September 21, 2019 |
| Last updated | July 20, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 2026030445 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.