Organization
MIDWEST BONE & JOINT SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELIX UNGACTA M.D. (ORTHOPEDIC SURGEON)
(618) 541-1406
Entity
Organization
Contact information
Practice address
11155 DUNN RD, SUITE 204, SAINT LOUIS, MO 63136-6150
(618) 654-5400
(618) 654-8787
Mailing address
30 APEX DR, SUITE 1, HIGHLAND, IL 62249-1285
(618) 654-5400
(618) 654-8787
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
106268
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215632
MEDICARE GROUP PROVIDER #
IL
Enumeration date
08/17/2011
Last updated
08/17/2011
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