Organization
MID-WEST PODIATRY & ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY PIKE (ADMINISTRATOR)
(314) 432-1903
Entity
Organization
Contact information
Practice address
11709 OLD BALLAS RD, SUITE 201, CREVE COEUR, MO 63141-7029
(314) 432-1903
(314) 432-5105
Mailing address
11709 OLD BALLAS RD, SUITE 201, CREVE COEUR, 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
—
365905413
—
MO
05
—
365906405
—
MO
Enumeration date
12/22/2006
Last updated
10/08/2009
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