Provider Demographics
NPI:1497739189
Name:BT HEART AND VASCULAR CENTER, PLLC
Entity Type:Organization
Organization Name:BT HEART AND VASCULAR CENTER, PLLC
Other - Org Name:THE HEART AND VASCULAR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGHIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-765-2500
Mailing Address - Street 1:150 CHARLOIS BLVD
Mailing Address - Street 2:SUITE 223
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1549
Mailing Address - Country:US
Mailing Address - Phone:336-765-2500
Mailing Address - Fax:336-765-2555
Practice Address - Street 1:150 CHARLOIS BLVD
Practice Address - Street 2:SUITE 223
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1549
Practice Address - Country:US
Practice Address - Phone:336-765-2500
Practice Address - Fax:336-765-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC124240207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528049269OtherPAULA CARTER
1750362430OtherDR. KENNETH RHINEHART
NC1003888066OtherTHEODORE KEITH, JR., MD
1275514986OtherDR. BEHZAD TAGHIZADEH
NC1386843498OtherAMY SPETZ, PA
NC1538112529OtherTIFFANY SPEAS, PA
NCDC6367OtherMEDICARE RR
NC5900341Medicaid
NC1629037387OtherALFRED RUFTY, JR., MD
NC0294LOtherBCBS
NC1134191273OtherCHARLES W HARRIS, JR., MD
1275514986OtherDR. BEHZAD TAGHIZADEH
VAC09298Medicare PIN