Organization
MIDWEST MEDICAL ASSOCIATES, INC
Active
Parent organization
MIDWEST MEDICAL ASSOCIATES, INC
Other names
Advanced Imaging Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST MEDICAL ASSOCIATES, INC
Authorized official
TAMMY HAMMA (IMAGING SERVICES DIRECTOR)
(314) 821-7227
Entity
Organization
Contact information
Practice address
3825 S LINDBERGH BLVD, SAINT LOUIS, MO 63127-1356
(317) 821-7227
(314) 821-2552
Mailing address
3825 S LINDBERGH BLVD, SAINT LOUIS, MO 63127-1356
(317) 821-7227
(314) 821-2552
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502461700
—
MO
01
—
CH3968
RR MEDICARE
MO
Enumeration date
05/15/2006
Last updated
12/20/2007
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