Organization
FOREST PARK NEUROLOGY, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA LOURDES DONATO M.D. (OFFICE MANAGER)
(816) 600-1816
Entity
Organization
Contact information
Practice address
3431 S STATE ROUTE 291, INDEPENDENCE, MO 64057-2341
(816) 600-1816
(816) 795-6966
Mailing address
3431 S STATE ROUTE 291, INDEPENDENCE, MO 64057-2341
(816) 600-1816
(816) 795-6966
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2008002407
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002924638 07
UNITED HEALTHCARE PROVIDER
MO
Enumeration date
05/31/2012
Last updated
05/31/2012
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