LEWIS C HALVERSON

BRIDGETON, MO
NPI1144253410
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: MO  R1J93)
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: IL  036078330)
2085R0204X Radiology, Vascular & Interventional Radiology
(Licence: IL  036078330)
2085R0204X Radiology, Vascular & Interventional Radiology
(Licence: MO  R1J93)
Enumeration Date2006-07-09
Last Update Date2020-11-10
Business Address
Dr. LEWIS C HALVERSON M.D.
12266 DE PAUL DR STE 315
BRIDGETON, MO 63044-2514
Phone number: 314-739-5858
Mailing Address
Dr. LEWIS C HALVERSON M.D.
220 COMPASS POINT DR
SAINT CHARLES, MO 63301-4405
Phone number: 636-947-4480