OrganizationActive
Fairview Heights Medical Group Sc
NPI 1780740936 · Medical Specialty Clinic/Center · Alton, IL
Provider details
- NPI number
- 1780740936
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Raymond Davidson, President
Mailing address
670 Mason Ridge Center Dr
Saint Louis, MO 63141-8573
Registry dates
- Enumerated
- 2006-12-29
- Last updated
- 2008-01-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.