Organization
NORTHWEST INFECTIOUS DISEASE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP G ZINSER MD (MANAGING PARTNER)
(314) 291-7997
Entity
Organization
Contact information
Practice address
12774 BOENKER LN, BRIDGETON, MO 63044
(314) 291-7997
(314) 739-1471
Mailing address
PO BOX 776874, CHICAGO, IL 60677-6874
(314) 291-7997
(314) 739-1471
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507780401
—
MO
Enumeration date
05/24/2006
Last updated
12/21/2023
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