Organization
INTENSIVIST GROUP OF MISSOURI INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY S. COWEN M.D. (PRESIDENT)
(866) 344-0543
Entity
Organization
Contact information
Practice address
1015 BOWLES AVE, FENTON, MO 63026-2394
(866) 344-0543
(866) 344-3934
Mailing address
830 W IL ROUTE 22, SUITE 50, LAKE ZURICH, IL 60047-2560
(866) 344-0543
(866) 344-3934
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
04/12/2010
Last updated
07/20/2010
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