MEDICARE: ADVANCED CARDIAC SPECIALISTS, CHARTERED

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	208800000X	Urology Physician
2	208600000X	Surgery Physician	30602	AZ
3	363LA2200X	Adult Health Nurse Practitioner
4	363AM0700X	Medical Physician Assistant
5	207RI0011X	Interventional Cardiology Physician
6	207UN0901X	Nuclear Cardiology Physician
7	2085B0100X	Body Imaging Physician
8	2085R0202X	Diagnostic Radiology Physician
9	2086S0129X	Vascular Surgery Physician	30602	AZ
10	207R00000X	Internal Medicine Physician	17159	AZ
11	207RC0000X	Cardiovascular Disease Physician	16175	AZ

General Provider Information

NPI Number	:	1235130824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CARDIAC SPECIALISTS, CHARTERED

Provider Business Mailing Address
First Line	:	PO BOX 63423
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85082-3423
Country	:	US
Telephone Number	:	480-892-2800
Fax Number	:	480-982-1400

Provider Business Practice Location Address
First Line	:	4838 E BASELINE RD
Second Line	:	BLDG. 2 STE. 110
City	:	MESA
State	:	AZ
Zip	:	85206-4671
Country	:	US
Telephone Number	:	480-892-2800
Fax Number	:	480-982-1400

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MR. WILLIAM FAZIO
Credential	:
Telephone Number	:	480-545-1808

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	09/15/2010

Similar Medicare Providers

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Practice Location Address:

4838 E BASELINE RD STE 117&118
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85206-4671

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1578418703 — NATHAN WILLIAMS
Practice Location Address:

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85206-4671

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1053267567 — SADIE ANDERSON
Practice Location Address:

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1992704266 — DR. HEZEKIAH UBOCHI CHINWAH M.D.
Practice Location Address:

4838 E BASELINE RD , BLDG. 2 STE. 110
MESA, AZ
85206-4671

Practice Phone: 480-892-2800
Practice Fax: 480-892-3258

1538150321 — DR. MICHAEL STUART BISCOE MD
Practice Location Address:

4838 E BASELINE RD , BLDG. 2 STE. 110
MESA, AZ
85206-4671

Practice Phone: 480-892-2800
Practice Fax: 480-892-3258

1376516955 — DR. RICHARD J LEWIS M.D.
Practice Location Address:

4838 E BASELINE RD , BLDG. 2 STE. 110
MESA, AZ
85206-4671

Practice Phone: 480-892-2800
Practice Fax: 480-892-3258

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