Halverson, Lewis C
Halverson, Lewis C is an individual health care provider with primary practice located at 12266 De Paul Dr Ste 315 , Bridgeton MO 63044-2514. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Halverson, Lewis C can be contacted via phone (314) 739-5858.Contact Information
Primary practice address
12266 De Paul Dr Ste 315
Bridgeton MO 63044-2514
Phone: (314) 739-5858
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036078330 | Illinois |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 036078330 | Illinois |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | R1J93 | Missouri |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | R1J93 | Missouri |
Profile Details
| NPI number | 1144253410 |
|---|---|
| LBN Legal business name | Halverson, Lewis C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2006 |
| Last updated | Nov 10th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144253410 | NPPES |
| Other | 300102491 | RAILROAD MEDICARE NUMBER | |
| MEDICAID | 202775904 | RAILROAD MEDICARE NUMBER | |
| MEDICAID | 036078330 | RAILROAD MEDICARE NUMBER | |
| Other | 300102486 | RAILROAD MEDICARE NUMBER |
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