Provider Demographics
NPI:1427229160
Name:THE HEART GROUP
Entity Type:Organization
Organization Name:THE HEART GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TATINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-464-0521
Mailing Address - Street 1:PO BOX 3316
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3316
Mailing Address - Country:US
Mailing Address - Phone:812-464-0521
Mailing Address - Fax:812-464-0565
Practice Address - Street 1:209 NW 11TH ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IL
Practice Address - Zip Code:62837-1218
Practice Address - Country:US
Practice Address - Phone:812-464-0521
Practice Address - Fax:812-464-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL947850Medicare PIN