Provider Demographics
NPI:1487848867
Name:POWERS CARDIOLOGY P C
Entity Type:Organization
Organization Name:POWERS CARDIOLOGY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-325-9671
Mailing Address - Street 1:607 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3346
Mailing Address - Country:US
Mailing Address - Phone:219-325-9671
Mailing Address - Fax:219-325-9482
Practice Address - Street 1:607 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3346
Practice Address - Country:US
Practice Address - Phone:219-325-9671
Practice Address - Fax:219-325-9482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045491207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000192667OtherANTHEM PIN
IN200908200AMedicaid
INF56722Medicare UPIN
IN200908200AMedicaid
IN177500Medicare PIN