Organization
MIDWEST MEDICINE GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANISHA PATWARDHAN MD (OWNER)
(314) 375-6630
Entity
Organization
Contact information
Practice address
14314 MANDERLEIGH WOODS DR, CHESTERFIELD, MO 63017-8055
(636) 566-8155
(636) 566-8732
Mailing address
PO BOX 958946, SAINT LOUIS, MO 63195-8946
(636) 566-8155
(636) 566-8732
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2000169533
MO
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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