Organization
MIDWEST MEDICAL ASSOCIATES, INC
Active
Other names
Clayton Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J COLLINS CORDER MD (OWNER)
(314) 872-9900
Entity
Organization
Contact information
Practice address
3009 N BALLAS RD, SUITE 300A, SAINT LOUIS, MO 63131-2322
(314) 872-9900
(314) 872-3939
Mailing address
3009 N BALLAS RD, SUITE 300A, SAINT LOUIS, MO 63131-2322
(314) 872-9900
(314) 872-3939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508139508
—
MO
Enumeration date
03/02/2006
Last updated
11/20/2008
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