Organization
INFECTIOUS DISEASE PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJEEV DEWAN MD (PRESIDENT)
(636) 333-4500
Entity
Organization
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(636) 333-4500
Mailing address
PO BOX 1413, O FALLON, IL 62269-8413
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
2004025502
MO
Other
Enumeration date
03/02/2011
Last updated
07/18/2012
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