MEDICARE: HILLCREST DIAGNOSTIC CARDIOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003870809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLCREST DIAGNOSTIC CARDIOLOGY

Provider Business Mailing Address
First Line	:	7500 OLD OAK BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3343
Country	:	US
Telephone Number	:	440-777-6300
Fax Number	:	440-777-2330

Provider Business Practice Location Address
First Line	:	6780 MAYFIELD RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124
Country	:	US
Telephone Number	:	440-312-4399
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ROBERT BOTTI JR
Credential	:	MD
Telephone Number	:	440-942-5400

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	02/19/2009

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