Healthcare Provider Details

I. General information

NPI: 1841237682
Provider Name (Legal Business Name): CARDIOVASCULAR IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 S LINDBERGH BLVD SUITE 250
SAINT LOUIS MO
63127-1368
US

IV. Provider business mailing address

PO BOX 1209
MARYLAND HEIGHTS MO
63043-0209
US

V. Phone/Fax

Practice location:
  • Phone: 314-849-0923
  • Fax: 314-849-5716
Mailing address:
  • Phone: 314-576-7213
  • Fax: 314-576-4755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License NumberR4P45
License Number StateMO

VIII. Authorized Official

Name: DR. RAFFI KRIKORIAN
Title or Position: OWNER
Credential:
Phone: 314-849-0923