Organization
SOUTH COUNTY IMAGING CENTER LLC
Active
Organization
SOUTH COUNTY IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABRAHAM S HAWATMEH MD (OWNER/PRESIDENT)
(314) 843-8000
Entity
Organization
Contact information
Practice address
12345 W BEND DR, STE 200, SAINT LOUIS, MO 63128-2104
(314) 843-8000
(314) 843-3004
Mailing address
12345 W BEND DR, STE 200, SAINT LOUIS, MO 63128-2104
(314) 843-8000
(314) 843-3004
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1078863
USA MCO
—
01
—
313190
GHP
MO
01
—
73674
HCUSA
MO
Enumeration date
08/29/2006
Last updated
04/20/2008
Update your record
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