Fairview Heights Medical Group Sc

NPI #1114110350 in Staunton, Illinois

Provider Information

NPI Number
1114110350
Entity Type
Organization
Organization Name
Fairview Heights Medical Group Sc
Primary Specialty
Internal Medicine - Cardiovascular Disease
Enumeration Date
Aug 21, 2007
Last Updated
Jan 7, 2008

Practice Location

Address
400 N CALDWELL ST
ZIP Code
62088-1423
Phone
(618) 635-2200

Authorized Official

Name
RAYMOND P DAVIDSON II, MD
Title
PRESIDENT
Phone
(314) 286-2028

Specialties & Taxonomy Codes

Specialty
Internal Medicine - Cardiovascular DiseaseCardiovascular Disease

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