| NPI | 1205557691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN T PHILLIPS Credentialing COO Rdinator 386-258-8722 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Additional Taxonomies | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology |
| 207RI0011X Internal Medicine Interventional Cardiology | |
| 207UN0901X Nuclear Medicine Nuclear Cardiology | |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2023-10-03 |