Provider Demographics
NPI:1194794198
Name:CARDIAC CONSULTANTS LLC
Entity type:Organization
Organization Name:CARDIAC CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSANDOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-897-9474
Mailing Address - Street 1:PO BOX 62076
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-2076
Mailing Address - Country:US
Mailing Address - Phone:410-280-6577
Mailing Address - Fax:410-280-6515
Practice Address - Street 1:888 BESTGATE RD
Practice Address - Street 2:SUITE 211
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3091
Practice Address - Country:US
Practice Address - Phone:410-897-9474
Practice Address - Fax:410-897-9476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5965OtherBCBS
KV68CAOtherBCBS
MD144800500Medicaid
KV68CAOtherBCBS
DN6919Medicare PIN
5965OtherBCBS