Provider Demographics
NPI:1770971434
Name:I-MED
Entity type:Organization
Organization Name:I-MED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LOVOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-387-5161
Mailing Address - Street 1:PO BOX 261017
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78426-1017
Mailing Address - Country:US
Mailing Address - Phone:361-387-5161
Mailing Address - Fax:361-232-5695
Practice Address - Street 1:13725 NORTHWEST BLVD
Practice Address - Street 2:STYE. 260
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5127
Practice Address - Country:US
Practice Address - Phone:361-387-5161
Practice Address - Fax:361-232-5695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty