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Organization

MID-MO LUNG ASSOCIATES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HUMAYUN LODHI MD (OWNER)
(573) 815-7118
Entity
Organization

Contact information

Practice address
1801 BROOKFIELD MNR, COLUMBIA, MO 65203-6246
(573) 815-7118
Mailing address
1801 BROOKFIELD MNR, COLUMBIA, MO 65203-6246
(573) 815-7118

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
117893
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500193800
MO
Enumeration date
08/24/2011
Last updated
08/29/2011
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