| Idim | |
|
1909 Larimer Trl Wildwood MO 63011-4801 | |
| (636) 273-5311 | |
| Not Available |
| Full Name | Idim |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 1909 Larimer Trl, Wildwood, Missouri |
| Authorized Official Name and Position | Alexandre Lacasse (PRESIDENT) |
| Authorized Official Contact | 6362735311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idim 1909 Larimer Trl Wildwood MO 63011-4801 Ph: (636) 273-5311 | Idim 1909 Larimer Trl Wildwood MO 63011-4801 Ph: (636) 273-5311 |
| NPI Number | 1588912448 |
|---|---|
| Provider Enumeration Date | 08/27/2012 |
| Last Update Date | 11/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588912448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 2006028227 (Missouri) | Primary |
Illinois Rural Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17781 Hornbean Dr, Wildwood, MO 63005 Phone: 312-953-5636 | |
Mercy Clinic Convenient Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16555 Manchester Rd Ste 110, Wildwood, MO 63040 Phone: 636-405-3155 Fax: 636-405-3162 | |
Altea Medical Missouri Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 Charic Dr, Wildwood, MO 63021 Phone: 636-394-2522 | |
Wildwood Internal Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16759 Main Street, Suite 203, Wildwood, MO 63040 Phone: 636-458-4800 Fax: 636-594-7500 |