Provider Demographics
NPI:1265697445
Name:CARDIOLOGY SPECIALISTS OF THE CAROLINAS, PA
Entity type:Organization
Organization Name:CARDIOLOGY SPECIALISTS OF THE CAROLINAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-369-8080
Mailing Address - Street 1:6836 MORRISON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2612
Mailing Address - Country:US
Mailing Address - Phone:704-369-8080
Mailing Address - Fax:
Practice Address - Street 1:6836 MORRISON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2612
Practice Address - Country:US
Practice Address - Phone:704-369-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-27
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty