Organization
CEP AMERICA ILLINOIS INTENSIVISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL MD (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2680
(510) 879-9074
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
02/02/2018
Last updated
03/30/2020
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