Midwest Medical Associates Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MO100186 Issued in MO

Legal business name

MIDWEST MEDICAL ASSOCIATES INC

Practice address

4346 Loughborough Ave
Saint Louis, MO 63116-2104

Phone

(314) 481-7030

Fax

(314) 481-7120

NPI assigned

Jul 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Alexander Rudoi, MD

Title

Physician

Phone

(314) 481-7030

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grandel Medical Former legal business name

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Midwest Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1417941584

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1992721047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 LOUGHBOROUGH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162104",
            "telephone_number": "314-481-7030",
            "fax_number": "314-481-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4346 LOUGHBOROUGH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162104",
            "telephone_number": "314-481-7030",
            "fax_number": "314-481-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "RUDOI",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "314-481-7030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "MO100186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DB2750",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grandel Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Midwest Infectious Disease Consultants LLC
• Midwest Innovation Laboratory LLC
• Midwest Internal Medicine &Cardiology, Inc.
• Midwest Internists, PC
• Midwest Lithotripsy, LLC
• Midwest Medical Associates Inc.
• Midwest Medical Associates, Inc
• Midwest Medical Associates, Inc
• Midwest Medical Associates, Inc
• Midwest Medical Associates, Inc.

• Primary Care Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.