Fairview Heights Medical Group Sc

NPI #1245373489 in Maryville, Illinois

Provider Information

NPI Number
1245373489
Entity Type
Organization
Organization Name
Fairview Heights Medical Group Sc
Primary Specialty
Internal Medicine - Cardiovascular Disease
Enumeration Date
Feb 15, 2007
Last Updated
Apr 2, 2008

Practice Location

Address
6810 STATE ROUTE 162
Address 2
SUITE 203
ZIP Code
62062-8501
Phone
(618) 288-5076

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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