| Mid-missouri Internal Medicine Inc | |
|
1050 W 10th St Ste 550 Rolla MO 65401-2905 | |
| (573) 364-7545 | |
| (573) 368-3672 |
| Full Name | Mid-missouri Internal Medicine Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1050 W 10th St Ste 550, Rolla, Missouri |
| Authorized Official Name and Position | Trish Leanne Klein (OFFICE MANAGER) |
| Authorized Official Contact | 5733647545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-missouri Internal Medicine Inc 1050 W 10th St Ste 550 Rolla MO 65401-2905 Ph: (573) 364-7545 | Mid-missouri Internal Medicine Inc 1050 W 10th St Ste 550 Rolla MO 65401-2905 Ph: (573) 364-7545 |
| NPI Number | 1508840901 |
|---|---|
| Provider Enumeration Date | 11/30/2005 |
| Last Update Date | 05/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508840901 | NPI | - | NPPES |
| 1436867 | Other | MO | UNITED HEALTHCARE |
| DG8365 | Other | MO | MEDICARE TRAVELERS |
| 123495 | Other | MO | BLUE CROSS BLUE SHIELD |
| 1013100866 | Other | MO | PROVIDER NPI |
| 504474602 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 34425 (Missouri) | Primary |
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