Organization
DM PHYSICIANS OF BELLEVILLE IL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD A SNOW (MANAGING PARTNER)
(336) 884-1830
Entity
Organization
Contact information
Practice address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
Mailing address
PO BOX 16068, HIGH POINT, NC 27261-6068
(336) 882-4615
(336) 884-1643
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
742065
HEALTHLINK PIN
—
Enumeration date
05/15/2006
Last updated
10/05/2007
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