Provider Demographics
NPI:1366779894
Name:SPRINGFIELD DIAGNOSTIC & INTERVENTIONAL CARDIOLOGY, INC.
Entity type:Organization
Organization Name:SPRINGFIELD DIAGNOSTIC & INTERVENTIONAL CARDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILHELM
Authorized Official - Middle Name:H
Authorized Official - Last Name:KALWEIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-390-5563
Mailing Address - Street 1:2200 N LIMESTONE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2665
Mailing Address - Country:US
Mailing Address - Phone:937-390-5563
Mailing Address - Fax:937-390-5566
Practice Address - Street 1:2200 N LIMESTONE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2665
Practice Address - Country:US
Practice Address - Phone:937-390-5563
Practice Address - Fax:937-390-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0634813Medicare PIN