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Organization
ADULT INTERNAL MEDICINE PRACTICE LLC
Active
Organization
ADULT INTERNAL MEDICINE PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W AMPADU M.D. (OWNER)
(618) 257-0780
Entity
Organization
Contact information
Practice address
15 PARK PL, SWANSEA, IL 62226-2918
(618) 257-0780
(618) 257-0715
Mailing address
15 PARK PL, SWANSEA, IL 62226-2918
(618) 257-0780
(618) 355-9972
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/11/2008
Last updated
09/06/2021
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