Organization
METRO CARDIOLOGY GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANULLAH K PATHAN M.D. (PRESIDENT)
(618) 239-3356
Entity
Organization
Contact information
Practice address
5020 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-3411
(618) 239-3356
(618) 239-3359
Mailing address
4600 MEMORIAL DR, SUITE 420, BELLEVILLE, IL 62226-5368
(618) 239-3356
(618) 239-3359
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036060909
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060909
—
IL
Enumeration date
05/27/2015
Last updated
05/27/2015
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