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General NPI Number Information
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NPI Number | 1063450674
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Entity Type | Organization
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Legal Business Name | THE CARDIOVASCULAR SPECIALISTS LLC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 90 TER HEUN DR SUITE 300
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City | FALMOUTH
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State | MA
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Zip | 02540-2533
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Country | US
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Telephone | 508-540-0604
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Fax | 508-495-7097
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Provider Business Mailing Address
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Address Line | 90 TER HEUN DR SUITE 300
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City | FALMOUTH
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State | MA
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Zip | 02540-2533
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Country | US
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Telephone | 508-540-0604
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Fax | 508-495-7097
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | DR. DAVID RALPH URBACH
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Credential | MD
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Telephone | 508-540-0604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 47033
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License Number State | MA
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