Healthcare Provider Details

I. General information

NPI: 1902820608
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 11/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 HILLPOINT BLVD N
SUFFOLK VA
23434-8470
US

IV. Provider business mailing address

1030 HILLPOINT BLVD N
SUFFOLK VA
23434-8470
US

V. Phone/Fax

Practice location:
  • Phone: 757-539-0444
  • Fax: 757-539-4824
Mailing address:
  • Phone: 757-539-0444
  • Fax: 757-539-4824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberVA-504-01
License Number StateVA

VIII. Authorized Official

Name: MRS. KIMBERLY H. GOLDEN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 757-539-0444