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Organization
MOSAIC MEDICAL CENTER - MARYVILLE
Active
Organization
MOSAIC MEDICAL CENTER - MARYVILLE
Active
Other names
Mosaic Family Care - Bedford
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT R CARVELL (DIRECTOR OF REIMBURSEMENT)
(816) 273-0473
Entity
Organization
Contact information
Practice address
408 DODGE ST, BEDFORD, IA 50833-1413
(712) 523-2738
(712) 523-3256
Mailing address
408 DODGE ST, BEDFORD, IA 50833-1413
(712) 523-2738
(712) 523-3256
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/22/2019
Last updated
06/10/2019
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