Provider Demographics
NPI:1407016389
Name:CARDIOLGY EAST PA
Entity Type:Organization
Organization Name:CARDIOLGY EAST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALOOF
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-838-3895
Mailing Address - Street 1:48 MEDICAL PARK DR E
Mailing Address - Street 2:SUITE 453
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3400
Mailing Address - Country:US
Mailing Address - Phone:205-838-3895
Mailing Address - Fax:205-838-3014
Practice Address - Street 1:48 MEDICAL PARK DR E
Practice Address - Street 2:SUITE 453
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3400
Practice Address - Country:US
Practice Address - Phone:205-838-3895
Practice Address - Fax:205-838-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2700207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty