| NPI | 1881900124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJEEV DEWAN Physician 618-624-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 2004025502) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 2008019273) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |