Lake Internal Med Special

NPI 1275719627 - Clinic/Center - 261QM2500X

NPI Details
NPI 1275719627
Enumeration Date 01/16/2008
Last Updated 01/16/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name M DAVID M
Position OWNER
Phone (573) 348-6700
Fax (573) 348-3310
Practice Location
980 EXECUTIVE DR
SUITE D
OSAGE BEACH MO, 65065-3495, US
Phone (573) 348-6700
Fax (573) 348-3310
Business Location
980 EXECUTIVE DR
SUITE D
OSAGE BEACH MO, 65065-3495, US
Phone (573) 348-6700
Fax (573) 348-3310
Toxanomy
Taxonomy Code 261QM2500X
License State Missouri
License Number RIE24
Remove 1275719627 NPI Number
 

According to our database, Lake Internal Med Special NPI is 1275719627, taxonomy code is 261QM2500X and license number is RIE24, license state is located at Missouri. Lake Internal Med Special physically located at 980 Executive Dr, Osage Beach MO, 65065-3495. NPI Number 1033115704 has the healthcare provider type.

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1275719627 NPI number is provided on an as is basis without warranty of any kind. 1275719627 is maintained by the National Plan & Provider Enumeration System. The contents of Lake Internal Med Special are for informational purposes only.