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General NPI Number Information
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NPI Number | 1619209996
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Entity Type | Organization
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Legal Business Name | MIDWEST RADIOLOGY SERVICES, LLC
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 16091 SWINGLEY RIDGE RD SUITE 100
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2056
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Country | US
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Telephone | 636-787-1350
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Fax | 636-519-7965
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Provider Business Mailing Address
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Address Line | 16091 SWINGLEY RIDGE RD SUITE 100
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2056
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Country | US
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Telephone | 636-787-1350
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Fax | 636-519-7965
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Authorized Official
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Title or Position | VICE PRESIDENT & COO
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Name | MR. GREGORY A SNEAD
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Credential |
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Telephone | 636-787-1350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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