Idim
Idim is an Infectious Disease Physician in Wildwood, Missouri. Licensed in Missouri. Registered with an NPI since 2012.
- Licensed in
- MO
- In the registry since
- 2012
Practice location Address checks out
1909 Larimer TrlWildwood, MO 63011-4801
Phone: (636) 273-5311
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Infectious Disease Physician (primary) | Taxonomy 207RI0200X · Licence 2006028227 (MO) |
|---|
Record details
| NPI number | 1588912448 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Alexandre Lacasse — President · (636) 273-5311 |
| NPI enumerated | August 27, 2012 |
| Last updated in NPPES | November 16, 2012 |
| Mailing address | 1909 Larimer Trl, Wildwood, MO 63011-4801 |