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General NPI Number Information
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NPI Number | 1659748846
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Entity Type | Organization
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Legal Business Name | ADVANCED CARDIOCARE INC
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 755 BOARDMAN CANFIELD RD SUITE H2
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City | BOARDMAN
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State | OH
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Zip | 44512-4300
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Country | US
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Telephone | 330-726-2000
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Fax | 330-406-1613
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Provider Business Mailing Address
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Address Line | 755 BOARDMAN CANFIELD RD SUITE H2
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City | BOARDMAN
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State | OH
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Zip | 44512-4300
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Country | US
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Telephone | 330-726-2000
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Fax | 330-406-1613
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Authorized Official
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Title or Position | PRESIDENT/PROVIDER
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Name | ATEF S LABIB
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Credential | M.D.
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Telephone | 330-726-2000
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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 | 35044422
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License Number State | OH
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