Provider Demographics
NPI:1174185524
Name:CHADI DIB MD PA
Entity Type:Organization
Organization Name:CHADI DIB MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:507-250-5129
Mailing Address - Street 1:2905 MOUNTAIN LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4073
Mailing Address - Country:US
Mailing Address - Phone:972-596-3481
Mailing Address - Fax:
Practice Address - Street 1:2905 MOUNTAIN LAUREL LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4073
Practice Address - Country:US
Practice Address - Phone:972-596-3481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-06
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty