AHI CARDIOVASCULAR SURGEONS LTD

Provider Demographics

• NPI: 1457508723
• Name: AHI CARDIOVASCULAR SURGEONS LTD
• Entity Type: Organization
• Organization Name: AHI CARDIOVASCULAR SURGEONS LTD
• Authorized Official - Title/Position: MEDICAL DIRECTOR
• Authorized Official - First Name: EDWARD
• Authorized Official - Middle Name: B
• Authorized Official - Last Name: DIETHRICH
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 602-266-2200
• Mailing Address - Street 1: PO BOX 52751
• Mailing Address - City: PHOENIX
• Mailing Address - State: AZ
• Mailing Address - Zip Code: 85072-2751
• Mailing Address - Country: US
• Mailing Address - Phone: 602-266-2200
• Mailing Address - Fax: 602-240-6177
• Practice Address - Street 1: 2632 N 20TH ST
• Practice Address - City: PHOENIX
• Practice Address - State: AZ
• Practice Address - Zip Code: 85006-1339
• Practice Address - Country: US
• Practice Address - Phone: 602-266-2200
• Practice Address - Fax: 602-240-6177
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: ARIZONA HEART INSTITUTE LTD
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2008-08-19
• Last Update Date: 2018-06-21

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	208G00000X	Allopathic & Osteopathic Physicians	Thoracic Surgery (Cardiothoracic Vascular Surgery)		Group - Multi-Specialty
No	207RC0000X	Allopathic & Osteopathic Physicians	Internal Medicine	Cardiovascular Disease	Group - Multi-Specialty
No	207RC0001X	Allopathic & Osteopathic Physicians	Internal Medicine	Clinical Cardiac Electrophysiology	Group - Multi-Specialty
No	207RC0200X	Allopathic & Osteopathic Physicians	Internal Medicine	Critical Care Medicine	Group - Multi-Specialty
No	207RI0011X	Allopathic & Osteopathic Physicians	Internal Medicine	Interventional Cardiology	Group - Multi-Specialty
No	207RP1001X	Allopathic & Osteopathic Physicians	Internal Medicine	Pulmonary Disease	Group - Multi-Specialty
No	2085R0204X	Allopathic & Osteopathic Physicians	Radiology	Vascular & Interventional Radiology	Group - Multi-Specialty
No	208600000X	Allopathic & Osteopathic Physicians	Surgery		Group - Multi-Specialty
No	2086S0129X	Allopathic & Osteopathic Physicians	Surgery	Vascular Surgery	Group - Multi-Specialty
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies		Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363AS0400X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Surgical	Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	363LA2200X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Adult Health	Group - Multi-Specialty
No	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
AZ	=========	Other	TAX-ID