MEDICARE: COMPREHENSIVE CARDIOLOGY CONSULTANTS

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	35047833	OH

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801126818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE CARDIOLOGY CONSULTANTS

Provider Business Mailing Address
First Line	:	311 STRAIGHT ST
Second Line	:	SUITE 301
City	:	CINCINNATI
State	:	OH
Zip	:	45219-1018
Country	:	US
Telephone Number	:	513-861-5555
Fax Number	:	513-861-0999

Provider Business Practice Location Address
First Line	:	3325 GLENMORE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6510
Country	:	US
Telephone Number	:	513-861-5555
Fax Number	:	513-861-0524

Authorized Official
Title or Position	:	CEO
Name	:	MR. GEORGE A WIETMARSCHEN
Credential	:
Telephone Number	:	513-872-5700

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	01/14/2010

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Directions to “COMPREHENSIVE CARDIOLOGY CONSULTANTS ” Practice Location

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