Northwest Otolaryngology, INC
Specialist in Bridgeton, MO. Organization (NPI-2).
NPI number1578747408
StatusActive
Last updated in NPPESOct 15, 2019
Details
- NPI
- 1578747408
- Entity type
- Organization (NPI-2)
- Legal business name
- Northwest Otolaryngology, INC
- Organization subpart
- No
- Enumeration date
- Dec 27, 2007
- Last updated
- Oct 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Other names
- Northwest Otolaryngology (Doing Business As)
Practice location
12255 De Paul Dr Ste 830nBridgeton, MO 63044-2510
Phone 314-291-5307 · Fax 314-291-0838
Mailing address
12255 De Paul Dr Ste 830nBridgeton, MO 63044-2510
Phone 314-291-5307 · Fax 314-291-0838
Authorized official
Melissa Budzinski
Billing Manager
6363796006
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