Provider Demographics
NPI:1689830671
Name:PEAK CARDIOLOGY, P.A
Entity Type:Organization
Organization Name:PEAK CARDIOLOGY, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHAR SRIVANI
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:AMBATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-363-6060
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2810
Mailing Address - Country:US
Mailing Address - Phone:919-363-6060
Mailing Address - Fax:919-363-6040
Practice Address - Street 1:1051 PEMBERTON HILL RD
Practice Address - Street 2:SUIT 202
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4267
Practice Address - Country:US
Practice Address - Phone:919-363-6060
Practice Address - Fax:919-363-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400448207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC141JMOtherBCBS
NC5902911Medicaid
NC0408294OtherGHI
NC207646OtherMEDCOST
NC207646OtherMEDCOST
NC5902911Medicaid