Provider Demographics
NPI:1508819012
Name:CARDIOLOGISTS, P.C.
Entity Type:Organization
Organization Name:CARDIOLOGISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HISHAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:WAGDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-364-7101
Mailing Address - Street 1:1002 4TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2425
Mailing Address - Country:US
Mailing Address - Phone:319-364-7101
Mailing Address - Fax:319-861-3014
Practice Address - Street 1:1002 4TH AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2425
Practice Address - Country:US
Practice Address - Phone:319-364-7101
Practice Address - Fax:319-861-3014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0193961Medicaid
IA0193961Medicaid