Organization
SOUTHWEST CARDIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID B STULTZ MD (PRESIDENT)
(937) 293-3486
Entity
Organization
Contact information
Practice address
8057 WASHINGTON VILLAGE DR, CENTERVILLE, OH 45458-1847
(937) 312-9890
(937) 293-3605
Mailing address
3533 SOUTHERN BLVD, SUITE 2100, KETTERING, OH 45429-1267
(937) 293-3486
(937) 293-3605
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020191600
BLACK LUNG PROGRAM
OH
01
—
060053779
RR MEDICARE
OH
01
—
1540749
THE FUNDS UMW
OH
05
—
2375700
—
OH
Enumeration date
06/16/2006
Last updated
02/11/2010
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