MEDICARE: CARDIOLOGY ASSOCIATES OF JOHNSTON, PLLC

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		NC

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	:	1013955574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY ASSOCIATES OF JOHNSTON, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 16325
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-6325
Country	:	US
Telephone Number	:	919-967-6646
Fax Number	:	919-967-6647

Provider Business Practice Location Address
First Line	:	11618 US HIGHWAY 70 W
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-2253
Country	:	US
Telephone Number	:	919-359-8040
Fax Number	:	919-359-8048

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KENNETH S FRIEDMAN
Credential	:	MD
Telephone Number	:	919-359-8040

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	07/24/2007

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Directions to “CARDIOLOGY ASSOCIATES OF JOHNSTON, PLLC ” Practice Location

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