An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Cardiovascular Disease |
207RC0000X | 11 | Physician/Internal Medicine | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI Number | 1710935002 |
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| LBN Legal business name | COTTAGE GROVE CARDIOLOGY, P.C. | ||||||||||||||||||||||||
| Authorized official | STACY SIMONS - (OFFICE ASSISTANT) | ||||||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||||||
| Enumeration date | 05/05/2006 | ||||||||||||||||||||||||
| Last updated | 11/05/2014 - About 12 years ago | ||||||||||||||||||||||||
| Identifiers |
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