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General NPI Number Information
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NPI Number | 1295749125
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY CENTER OF DALTON PC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | 1411 CHATTANOOGA AVE SUITE 101
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City | DALTON
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State | GA
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Zip | 30720-2673
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Country | US
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Telephone | 706-272-0272
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Fax | 706-272-0276
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Provider Business Mailing Address
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Address Line | 1411 CHATTANOOGA AVE
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City | DALTON
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State | GA
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Zip | 30720
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Country | US
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Telephone | 706-272-0272
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Fax | 706-272-0276
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EZAD N AHMAD
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Credential | M.D.
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Telephone | 706-272-0272
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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 | 038162
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License Number State | GA
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