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General NPI Number Information
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NPI Number | 1376571380
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Entity Type | Organization
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Legal Business Name | BOSTON WEST CARDIOLOGY PC
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 20 HOPE AVE SUITE G07
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City | WALTHAM
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State | MA
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Zip | 02453-2721
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Country | US
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Telephone | 781-894-1199
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Fax |
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Provider Business Mailing Address
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Address Line | 20 HOPE AVE SUITE G07
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City | WALTHAM
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State | MA
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Zip | 02453-2721
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Country | US
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Telephone | 781-894-1199
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RIFAT B DWEIK
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Credential | M.D.
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Telephone | 781-894-1199
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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 | 58014
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License Number State | MA
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