Provider Demographics
NPI:1568633121
Name:INFORMED MEDICAL DECISIONS, INC.
Entity Type:Organization
Organization Name:INFORMED MEDICAL DECISIONS, INC.
Other - Org Name:INFORMED DNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-778-4434
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33731-0491
Mailing Address - Country:US
Mailing Address - Phone:800-975-4819
Mailing Address - Fax:800-930-0961
Practice Address - Street 1:111 2ND AVE NE STE 700
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3441
Practice Address - Country:US
Practice Address - Phone:760-778-4434
Practice Address - Fax:800-930-0961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170300000XOther Service ProvidersGenetic Counselor, MSGroup - Single Specialty