Provider Demographics
NPI:1740232859
Name:BI-STATE CARDIOVASCULAR CONSULTANT PC
Entity Type:Organization
Organization Name:BI-STATE CARDIOVASCULAR CONSULTANT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-835-0001
Mailing Address - Street 1:PO BOX 66940
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63166-6940
Mailing Address - Country:US
Mailing Address - Phone:618-282-1109
Mailing Address - Fax:314-835-0030
Practice Address - Street 1:2705 DOUGHERTY FERRY RD STE 201
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3372
Practice Address - Country:US
Practice Address - Phone:314-835-0001
Practice Address - Fax:314-835-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty