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General NPI Number Information
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NPI Number | 1417941584
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Entity Type | Organization
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Legal Business Name | MIDWEST MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 7345 WATSON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63119-4405
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Country | US
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Telephone | 314-752-7100
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Fax | 314-752-3284
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Provider Business Mailing Address
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Address Line | 7345 WATSON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63119-4405
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Country | US
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Telephone | 314-752-7100
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Fax | 314-752-3284
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Authorized Official
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Title or Position | PRESIDENT / MEDICAL DIRECTOR
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Name | PATRICK F GARRETT
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Credential | M.D.
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Telephone | 314-752-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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