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General NPI Number Information
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NPI Number | 1144258021
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR DIAGNOSTIC CENTER
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 1200 N ELM ST
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City | GREENSBORO
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State | NC
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Zip | 27401-1020
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Country | US
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Telephone | 336-832-2771
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Fax | 336-832-8844
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Provider Business Mailing Address
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Address Line | 1200 N ELM ST
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City | GREENSBORO
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State | NC
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Zip | 27401-1004
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Country | US
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Telephone | 336-832-2771
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Fax | 336-832-8844
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MR. RICHARD B LUNDY
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Credential | MBA
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Telephone | 336-832-7951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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