Provider Demographics
NPI:1841234606
Name:BILTMORE CARDIOLOGY, PLLC
Entity Type:Organization
Organization Name:BILTMORE CARDIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-952-0002
Mailing Address - Street 1:4444 N 32ND ST
Mailing Address - Street 2:SUITE 175
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3956
Mailing Address - Country:US
Mailing Address - Phone:602-952-0002
Mailing Address - Fax:602-224-9119
Practice Address - Street 1:4444 N 32ND ST
Practice Address - Street 2:SUITE 175
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3956
Practice Address - Country:US
Practice Address - Phone:602-952-0002
Practice Address - Fax:602-224-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07469506D174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWDBBMMedicare ID - Type Unspecified