Organization
MID-TOWN MEDICAL PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IQBAL AMIN M.D. (PRESIDENT)
(314) 651-6132
Entity
Organization
Contact information
Practice address
9 SACKSTON WOODS LN, CREVE COEUR, MO 63141-8228
(314) 651-6132
Mailing address
424 W 4TH ST, WATERLOO, IL 62298-1378
(877) 748-7030
(877) 264-9140
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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