Provider Demographics
NPI:1649262064
Name:INTEGRATIVE CARDIOLOGY PLLC
Entity type:Organization
Organization Name:INTEGRATIVE CARDIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNE MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEYRER MELK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-941-0800
Mailing Address - Street 1:7700 E INDIAN SCHOOL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4043
Mailing Address - Country:US
Mailing Address - Phone:480-941-0800
Mailing Address - Fax:480-941-8333
Practice Address - Street 1:7700 E INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4043
Practice Address - Country:US
Practice Address - Phone:480-941-0800
Practice Address - Fax:480-941-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ864047207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ60343Medicare PIN