| NPI | 1679742480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY CARSON Manager, Payer Enrollment 234-312-5691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology | |
| 207RI0011X Internal Medicine Interventional Cardiology | |
| 207RA0001X Internal Medicine Advanced Heart Failure and Transplant Cardiology | |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2024-10-29 |