Provider Demographics
NPI:1912950585
Name:GASTROINTESTINAL ASSOCIATES, LLP
Entity type:Organization
Organization Name:GASTROINTESTINAL ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ-ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-777-8818
Mailing Address - Street 1:210 PORTLAND ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6677
Mailing Address - Country:US
Mailing Address - Phone:573-777-8818
Mailing Address - Fax:573-777-8819
Practice Address - Street 1:210 PORTLAND ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6677
Practice Address - Country:US
Practice Address - Phone:573-777-8818
Practice Address - Fax:573-777-8819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000013132Medicare ID - Type Unspecified