Provider Demographics
NPI:1134532419
Name:DOCTORS ON THE GO LLC
Entity type:Organization
Organization Name:DOCTORS ON THE GO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-216-0838
Mailing Address - Street 1:1515 N WARSON RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:OLIVETTE
Mailing Address - State:MO
Mailing Address - Zip Code:63132-1111
Mailing Address - Country:US
Mailing Address - Phone:314-216-0838
Mailing Address - Fax:
Practice Address - Street 1:1515 N WARSON RD
Practice Address - Street 2:SUITE 111
Practice Address - City:OLIVETTE
Practice Address - State:MO
Practice Address - Zip Code:63132-1111
Practice Address - Country:US
Practice Address - Phone:314-216-0838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty