Provider Demographics
NPI:1073819207
Name:CLINICAL DECISION MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:CLINICAL DECISION MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-286-1833
Mailing Address - Street 1:1807 CAPITOL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1807 CAPITOL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4544
Practice Address - Country:US
Practice Address - Phone:307-286-1833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-05
Last Update Date:2011-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty