Organization
MIDWEST NEUROSCIENCE PC
Active
Organization
MIDWEST NEUROSCIENCE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES D DONOHOE M.D. (PHYSICIAN)
(816) 373-3213
Entity
Organization
Contact information
Practice address
17020 E 40 HWY, SUITE 8, INDEPENDENCE, MO 64055-5365
(816) 373-3213
(816) 373-6209
Mailing address
17020 E 40 HWY, SUITE 8, INDEPENDENCE, MO 64055-5365
(816) 373-3213
(816) 373-6209
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R7396
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209250703
—
MO
01
—
R7396
LICENSE NUMBNER
MO
Enumeration date
08/07/2007
Last updated
06/03/2011
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