Organization
HAVASU LUNG AND SLEEP DISORDERS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI A BERDIN M.D. (OWNER/MEMBER)
(928) 855-6966
Entity
Organization
Contact information
Practice address
1830 MESQUITE AVE, STE C, LAKE HAVASU CITY, AZ 86403-5885
(928) 855-6966
(928) 855-6974
Mailing address
PO BOX 4559, LAKE HAVASU CITY, AZ 86405-4559
(928) 855-6966
(928) 855-6974
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
42565
AZ
207RP1001X
Pulmonary Disease Physician
Primary
42565
AZ
207RS0012X
Sleep Medicine (Internal Medicine) Physician
42565
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
480404
—
AZ
01
—
L-1566579-8
CORPORATION NUMBER
AZ
Enumeration date
11/16/2009
Last updated
10/25/2010
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