Provider Demographics
NPI:1811918659
Name:PREMIER HEART ASSOCIATES , INC
Entity type:Organization
Organization Name:PREMIER HEART ASSOCIATES , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUL-KARIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-832-2425
Mailing Address - Street 1:800 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869-1041
Mailing Address - Country:US
Mailing Address - Phone:937-832-2425
Mailing Address - Fax:937-832-9804
Practice Address - Street 1:800 E MONROE ST
Practice Address - Street 2:
Practice Address - City:NEW BREMEN
Practice Address - State:OH
Practice Address - Zip Code:45869-1041
Practice Address - Country:US
Practice Address - Phone:937-832-2425
Practice Address - Fax:937-832-9804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2303279Medicaid
OH2303279Medicaid