Provider Demographics
NPI:1023204914
Name:CARDIOLOGY ASSOCIATES OF ANDERSON,PA
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF ANDERSON,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DWIGHT
Authorized Official - Last Name:WARE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:864-375-9090
Mailing Address - Street 1:105 BUFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3313
Mailing Address - Country:US
Mailing Address - Phone:864-375-9090
Mailing Address - Fax:864-260-0194
Practice Address - Street 1:105 BUFORD AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3313
Practice Address - Country:US
Practice Address - Phone:864-375-9090
Practice Address - Fax:864-260-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9254207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD99377Medicare UPIN
SC4236Medicare PIN