Provider Demographics
NPI:1497999049
Name:CARDIOLOGY CONSULTANTS LTD
Entity Type:Organization
Organization Name:CARDIOLOGY CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:RADKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-560-1811
Mailing Address - Street 1:PO BOX 4241
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63006-4241
Mailing Address - Country:US
Mailing Address - Phone:314-560-1811
Mailing Address - Fax:
Practice Address - Street 1:14855 N OUTER 40
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2026
Practice Address - Country:US
Practice Address - Phone:636-532-0150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty