Provider Demographics
NPI:1033596515
Name:PREMIER CARDIOLOGY CONSULTANTS INC
Entity Type:Organization
Organization Name:PREMIER CARDIOLOGY CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIDAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:YUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-699-6396
Mailing Address - Street 1:1118 ROSS CLARK CIR
Mailing Address - Street 2:STE 704
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3001
Mailing Address - Country:US
Mailing Address - Phone:334-699-6396
Mailing Address - Fax:334-699-6398
Practice Address - Street 1:1118 ROSS CLARK CIR
Practice Address - Street 2:STE 704
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3001
Practice Address - Country:US
Practice Address - Phone:334-699-6396
Practice Address - Fax:334-699-6398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD 29518207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty