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General NPI Number Information
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NPI Number | 1366434854
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Entity Type | Organization
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Legal Business Name | HEARTLAND CARDIOLOGY PC
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 8552 CASS ST #308
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City | OMAHA
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State | NE
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Zip | 68114-3570
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Country | US
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Telephone | 402-991-5300
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Fax | 402-991-5407
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Provider Business Mailing Address
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Address Line | 8552 CASS ST #308
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City | OMAHA
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State | NE
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Zip | 68114-3570
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Country | US
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Telephone | 402-991-5300
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Fax | 402-991-5407
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER D MCLEAY
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Credential | MD
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Telephone | 402-991-5300
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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 | 30071
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 18014
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License Number State | NE
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