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General NPI Number Information
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NPI Number | 1356789010
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Entity Type | Organization
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Legal Business Name | DOMINION HEART AND VASCULAR CLINIC
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 563 SOUTHPARK BLVD
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834
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Country | US
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Telephone | 804-621-7262
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11393
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City | RICHMOND
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State | VA
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Zip | 23230-1393
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Country | US
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Telephone | 804-621-7262
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Fax | 877-840-9785
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Authorized Official
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Title or Position | OWNER
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Name | SAQUIB SAMEE
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Credential | MD
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Telephone | 804-833-8048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 0101235808
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License Number State | VA
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