Basic Information
| Provider Information | |||||||||
| NPI: | 1912950585 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GASTROINTESTINAL ASSOCIATES, LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 PORTLAND ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652016677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737778818 | ||||||||
| FaxNumber: | 5737778819 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 PORTLAND ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652016677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737778818 | ||||||||
| FaxNumber: | 5737778819 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 06/30/2010 | ||||||||
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| AuthorizedOfficialLastName: | DIAZ-ARIAS | ||||||||
| AuthorizedOfficialFirstName: | MICHELE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 5737778818 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.