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General NPI Number Information
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NPI Number | 1548287527
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Entity Type | Organization
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Legal Business Name | MIDWEST HEART RHYTHM INCORPORATED
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 10/03/2017
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Provider Practice Location Address
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Address Line | 222 S WOODS MILL RD SUITE 400N
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3625
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Country | US
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Telephone | 314-317-9863
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Fax | 314-317-9806
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Provider Business Mailing Address
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Address Line | PO BOX 952273
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City | SAINT LOUIS
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State | MO
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Zip | 63195-2273
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Country | US
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Telephone | 314-432-2580
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Fax | 314-432-0223
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Authorized Official
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Title or Position | MD
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Name | CAREY S FREDMAN
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Credential | MD
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Telephone | 314-317-9863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | R5G76
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | R4D51
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License Number State | MO
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