Provider Demographics
NPI:1760610356
Name:FAYETTE SPECIALTY ASSOCIATES CARDIOLOGY
Entity Type:Organization
Organization Name:FAYETTE SPECIALTY ASSOCIATES CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-430-5797
Mailing Address - Street 1:211 EASY ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3129
Mailing Address - Country:US
Mailing Address - Phone:724-438-6661
Mailing Address - Fax:724-438-6665
Practice Address - Street 1:211 EASY ST
Practice Address - Street 2:SUITE 214
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3129
Practice Address - Country:US
Practice Address - Phone:724-438-6661
Practice Address - Fax:724-438-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty