Organization
INTENSIVE CARE CONSORTIUM - MIDWEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MOAS (PRESIDENT)
(786) 494-5154
Entity
Organization
Contact information
Practice address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-2000
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 373-7406
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
11/21/2025
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