Provider Demographics
NPI:1437689262
Name:BILTMORE DIAGNOSTICS
Entity Type:Organization
Organization Name:BILTMORE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZAHEER
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-486-9456
Mailing Address - Street 1:2163 E BASELINE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1541
Mailing Address - Country:US
Mailing Address - Phone:401-641-5867
Mailing Address - Fax:
Practice Address - Street 1:17500 N PERIMETER DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7800
Practice Address - Country:US
Practice Address - Phone:480-586-2210
Practice Address - Fax:480-586-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ48441207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty