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General NPI Number Information
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NPI Number | 1487848867
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Entity Type | Organization
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Legal Business Name | POWERS CARDIOLOGY P C
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | 607 JEFFERSON AVE
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City | LA PORTE
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State | IN
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Zip | 46350-3346
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Country | US
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Telephone | 219-325-9671
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Fax | 219-325-9482
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Provider Business Mailing Address
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Address Line | 607 JEFFERSON AVE
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City | LA PORTE
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State | IN
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Zip | 46350-3346
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Country | US
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Telephone | 219-325-9671
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Fax | 219-325-9482
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER DENNIS POWERS
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Credential | MD
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Telephone | 219-325-9671
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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 | 01045491
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License Number State | IN
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