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General NPI Number Information
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NPI Number | 1669133260
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Entity Type | Organization
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Legal Business Name | EAU CLAIRE HEART INSTITUTE
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 659 WEST HAMILTON AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6925
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Country | US
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Telephone | 715-831-4444
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Fax | 920-526-5248
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Provider Business Mailing Address
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Address Line | 659 WEST HAMILTON AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6925
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Country | US
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Telephone | 715-831-4444
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Fax | 920-526-5248
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABD G. KHATIB
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Credential |
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Telephone | 715-831-4444
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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 |
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License Number State |
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