Organization
DIAGNOSTIC CARDIOLOGY SERVICES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMER THANAVARO MD (MD)
(618) 433-1861
Entity
Organization
Contact information
Practice address
2 MEMORIAL DR STE 106, ALTON, IL 62002-6723
(618) 433-1861
(618) 433-9274
Mailing address
2 MEMORIAL DR STE 106, ALTON, IL 62002-6723
(618) 433-1861
(618) 433-9274
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501945000
—
MO
Enumeration date
06/19/2006
Last updated
08/11/2021
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