| Organization Name: | OVERLAND MEDICAL CENTER |
| NPI Number: | 1679637870 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BEN GOLDSTEIN (OFFICER) |
| Mailing Address: | 2428 Woodson Rd Overland |
| State: | MO US |
| Postal Code: | 631145423 |
| Phone Number: | 3144272424 |
| Fax Number: | 3144277787 |
| NPI Enumeration Date: | 12/21/2006 |
| NPI Last Update Date: | 02/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |