Provider Demographics
NPI:1558615526
Name:ADVANTAGE CARDIOLOGY INC
Entity Type:Organization
Organization Name:ADVANTAGE CARDIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EBERE
Authorized Official - Middle Name:MAXWELL
Authorized Official - Last Name:UGWANYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-222-1100
Mailing Address - Street 1:PO BOX 11544
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4006
Mailing Address - Country:US
Mailing Address - Phone:419-222-1100
Mailing Address - Fax:419-222-1104
Practice Address - Street 1:920 W MARKET ST
Practice Address - Street 2:SUITE 330
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2773
Practice Address - Country:US
Practice Address - Phone:419-222-1100
Practice Address - Fax:419-222-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35091558207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHUG4237541Medicare PIN
OHG90827Medicare UPIN