Healthcare Provider Details

I. General information

NPI: 1023069994
Provider Name (Legal Business Name): MIDWEST ACUTE CARE CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11155 DUNN RD STE: 315E
SAINT LOUIS MO
63136-6150
US

IV. Provider business mailing address

PO BOX 66936
SAINT LOUIS MO
63166-6936
US

V. Phone/Fax

Practice location:
  • Phone: 314-355-7500
  • Fax: 314-355-3287
Mailing address:
  • Phone: 314-355-7500
  • Fax: 314-355-3287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NAT T LEVY
Title or Position: PRESIDENT
Credential: MD
Phone: 314-355-7500