Individual
GIRISH R MOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
340 W LINCOLN ST, SUITE 400, BELLEVILLE, IL 62220-1900
(618) 233-6044
Mailing address
340 W LINCOLN ST, SUITE 400, BELLEVILLE, IL 62220-1900
(618) 233-6044
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036133156
IL
207RC0000X
Cardiovascular Disease Physician
35086063
OH
207RC0000X
Cardiovascular Disease Physician
TP573
KY
207RI0011X
Interventional Cardiology Physician
Primary
14145
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201320850
—
IN
05
—
2586705
—
OH
05
—
7100360210
—
KY
Enumeration date
09/25/2006
Last updated
01/08/2022
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