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General NPI Number Information
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NPI Number | 1144279241
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Entity Type | Organization
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Legal Business Name | CARDIODIAGNOSTICS, PC
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1500 S LAKE PARK AVE
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City | HOBART
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State | IN
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Zip | 46342-6638
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Country | US
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Telephone | 219-942-0551
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Fax | 219-738-6714
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Provider Business Mailing Address
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Address Line | 55 E 86TH AVE PO BOX 10645
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6382
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Country | US
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Telephone | 219-769-1670
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Fax | 219-738-6714
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Authorized Official
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Title or Position | PRESIDENT
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Name | THACH NGUYEN
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Credential | MD
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Telephone | 219-769-1670
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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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