Organization
MEDWIN PRIMARY CARE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURMANADHA GREEN (BILLING MANAGER)
(314) 878-0163
Entity
Organization
Contact information
Practice address
3619 RICHARDSON SQUARE DR, ARNOLD, MO 63010-6022
(636) 461-1414
Mailing address
PO BOX 797052, SAINT LOUIS, MO 63179-7000
(636) 461-1414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
105197
MO
Other
Enumeration date
08/05/2006
Last updated
09/26/2012
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