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General NPI Number Information
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NPI Number | 1245250786
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR SPECIALISTS, INC.
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 3235 ACADEMY AVE SUITE 201
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City | PORTSMOUTH
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State | VA
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Zip | 23703-3200
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Country | US
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Telephone | 757-483-6420
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Fax | 757-638-4519
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Provider Business Mailing Address
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Address Line | 3235 ACADEMY AVE SUITE 201
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City | PORTSMOUTH
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State | VA
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Zip | 23703-3200
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Country | US
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Telephone | 757-483-6420
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Fax | 757-638-4519
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | AMY M. CLARK
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Credential | CPC
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Telephone | 757-483-6420
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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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