Fairview Heights Medical Group Sc

NPI #1528199718 in Alton, Illinois

Provider Information

NPI Number
1528199718
Entity Type
Organization
Organization Name
Fairview Heights Medical Group Sc
Primary Specialty
Family Medicine
Enumeration Date
Mar 8, 2007
Last Updated
Jan 7, 2008

Practice Location

Address
230 REGIONAL DR
City
Alton
ZIP Code
62002-5942
Phone
(618) 465-7080

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Family Medicine

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