MIDWEST INTERNAL MEDICINE PLLC NPI 1619174604

NPI Information

MIDWEST INTERNAL MEDICINE PLLC is a specialist in Lake Havasu City, AZ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MIDWEST INTERNAL MEDICINE PLLC NPI is 1619174604. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Midwest Mri.

The provider's business location address is:

1840 MESQUITE AVE
SUITE B
LAKE HAVASU CITY, AZ
ZIP 86403-771
Phone: (928) 453-8500
Fax: (928) 453-5556

The provider's authorized official is Marty Lalande .
The authorized official title is Administrator and has the following contact phone number (928) 453-8500.

The CLIA number assigned to this NPI record is 03D0967428 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/2/2007 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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