MEDICARE: CARDIOVASCULAR CONSULTANTS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538106711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULAR CONSULTANTS PC

Provider Business Mailing Address
First Line	:	10010 DONALD S POWERS DR
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-4054
Country	:	US
Telephone Number	:	732-335-6515
Fax Number	:	219-922-5904

Provider Business Practice Location Address
First Line	:	10010 DONALD POWERS DRIVE
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321
Country	:	US
Telephone Number	:	219-934-4200
Fax Number	:	219-922-5904

Authorized Official
Title or Position	:	MANAGER
Name	:	SHEILA SELMON
Credential	:
Telephone Number	:	732-335-6515

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	01/08/2026

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