Organization
DIGESTIVE DISEASE MEDICAL CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID H. CORT M.D. (VICE-PRESIDENT)
(636) 561-9020
Entity
Organization
Contact information
Practice address
200 BREVCO PLZ, SUITE 208, LAKE ST LOUIS, MO 63367-2949
(636) 561-9020
(636) 561-6208
Mailing address
200 BREVCO PLZ, SUITE 208, LAKE ST LOUIS, MO 63367-2949
(636) 561-9020
(636) 561-6208
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502983109
—
MO
01
—
CC9057
RAILROAD MEDICARE GROUP #
MO
Enumeration date
08/18/2006
Last updated
03/30/2011
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