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ICAN CLINIC MO PC NPI 1992461776


NPI Information

NPI: 1992461776
Provider Name: ICAN CLINIC MO PC
Classification: Surgery - 208600000X
Entity Type: Organization

CLIA Number: 14D2201731

Address:
106 FOUR SEASONS SHOPPING CTR STE 110
CHESTERFIELD, MO
ZIP 63017
Phone: (618) 254-2273
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ICAN CLINIC MO PC is a surgery in Chesterfield, MO. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. ICAN CLINIC MO PC NPI is 1992461776. The provider is registered as an organization entity type.

The provider's business location address is:

106 FOUR SEASONS SHOPPING CTR STE 110
CHESTERFIELD, MO
ZIP 63017-173
Phone: (618) 254-2273

The provider's authorized official is Michael Harbison .
The authorized official title is Owner and has the following contact phone number (618) 254-2273.

The CLIA number assigned to this NPI record is 14D2201731 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/16/2021 and was last updated on 11/16/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP3300XClinic/CenterPainNo
2208600000XSurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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