| NPI | 1649584921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA K. MCDONALD Credentialing Coodinator 618-257-4644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2013-02-15 |