Organization
MID-WEST PODIATRY AND ASSOCIATES, L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HIEU NGUYEN (ADMINISTRATOR)
(314) 432-5683
Entity
Organization
Contact information
Practice address
12818 TESSON FERRY RD STE 201, SAINT LOUIS, MO 63128-2945
(314) 894-4684
(314) 892-0836
Mailing address
11709 OLD BALLAS RD STE 201, SAINT LOUIS, MO 63141-7029
(314) 432-1903
(314) 432-5105
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365905405
—
MO
05
—
365905413
—
MO
Enumeration date
12/27/2006
Last updated
10/13/2021
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