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FAIRVIEW HEIGHTS MEDICAL GROUP SC NPI 1245373489


NPI Information

NPI: 1245373489
Provider Name: FAIRVIEW HEIGHTS MEDICAL GROUP SC

Doing Business As: THE HEART CARE GROUP

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
6810 STATE ROUTE 162
SUITE 203
MARYVILLE, IL
ZIP 62062
Phone: (618) 288-5076
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FAIRVIEW HEIGHTS MEDICAL GROUP SC is a cardiovascular disease internal medicine in Maryville, IL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. FAIRVIEW HEIGHTS MEDICAL GROUP SC NPI is 1245373489. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As The Heart Care Group.

The provider's business location address is:

6810 STATE ROUTE 162
SUITE 203
MARYVILLE, IL
ZIP 62062-501
Phone: (618) 288-5076

The provider's authorized official is Raymond P Davidson .
The authorized official title is President and has the following contact phone number (314) 286-2028.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 4/2/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1413610MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
2413610MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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