Provider Demographics
NPI:1235365123
Name:HEART CLINICS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HEART CLINICS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-756-8400
Mailing Address - Street 1:311 E 89TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8126
Mailing Address - Country:US
Mailing Address - Phone:219-756-8400
Mailing Address - Fax:219-756-8001
Practice Address - Street 1:311 E 89TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-8126
Practice Address - Country:US
Practice Address - Phone:219-756-8400
Practice Address - Fax:219-756-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01044106A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty