Provider Demographics
NPI:1326069469
Name:LUNG AND ASTHMA CLINIC OF SAINT JOSEPH, PC
Entity Type:Organization
Organization Name:LUNG AND ASTHMA CLINIC OF SAINT JOSEPH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEMANT
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP
Authorized Official - Phone:816-390-8300
Mailing Address - Street 1:1502 N 36TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2306
Mailing Address - Country:US
Mailing Address - Phone:816-390-8300
Mailing Address - Fax:816-390-8047
Practice Address - Street 1:1502 N 36TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2306
Practice Address - Country:US
Practice Address - Phone:816-390-8300
Practice Address - Fax:816-390-8047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMDR2P06207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MON320000Medicare ID - Type UnspecifiedGROUP NUMBER