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Organization

AG CARDIOLOGY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ALI R GHASEMZADEH M.D. (OWNER PRESIDENT)
(937) 378-9090
Entity
Organization

Contact information

Practice address
5062 STATE ROUTE 125, GEORGETOWN, OH 45121-9561
(937) 378-9090
(937) 378-0102
Mailing address
PO BOX 577, GEORGETOWN, OH 45121-0577
(937) 378-9090
(937) 378-0102

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35080480G
OH
207RC0000X
Cardiovascular Disease Physician
38551
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2291738
OH
05
64073497
KY
Enumeration date
01/30/2008
Last updated
03/27/2012
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