Provider Demographics
NPI:1831123033
Name:MANSFIELD CARDIOLOGY AND INTERNISTS, INC.
Entity Type:Organization
Organization Name:MANSFIELD CARDIOLOGY AND INTERNISTS, INC.
Other - Org Name:BHAT AND PADIVAL, MD'S, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-756-2177
Mailing Address - Street 1:275 CLINE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1019
Mailing Address - Country:US
Mailing Address - Phone:419-756-2177
Mailing Address - Fax:419-756-4258
Practice Address - Street 1:275 CLINE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1019
Practice Address - Country:US
Practice Address - Phone:419-756-2177
Practice Address - Fax:419-756-4258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3542607207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBH9177892Medicare PIN
OHBH9177894Medicare PIN