MIDWEST MEDICAL ASSOCIATES INC NPI 1992721047

NPI Information

NPI: 1992721047
Provider Name: MIDWEST MEDICAL ASSOCIATES INC

Former Legal Business Name: GRANDEL MEDICAL

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
4346 LOUGHBOROUGH AVE
SAINT LOUIS, MO
ZIP 63116
Phone: (314) 481-7030
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MIDWEST MEDICAL ASSOCIATES INC is a primary care clinic center in Saint Louis, MO. MIDWEST MEDICAL ASSOCIATES INC NPI is 1992721047. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Grandel Medical.

The provider's business location address is:

4346 LOUGHBOROUGH AVE
SAINT LOUIS, MO
ZIP 63116-104
Phone: (314) 481-7030
Fax: (314) 481-7120

The provider's authorized official is Alexander Rudoi .
The authorized official title is Physician and has the following contact phone number (314) 481-7030.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 11/13/2007.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	MO100186	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DB2750	OTHER	MISSOURI	MEDICARE RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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