Organization
ARIZONA HEART INSTITUTE SCW
Active
Parent organization
ARIZONA HEART INSTITUTE LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARIZONA HEART INSTITUTE LTD
Authorized official
EDWARD DIETHRICH M.D. (MEDICAL DIRECTOR)
(602) 266-2200
Entity
Organization
Contact information
Practice address
13967 W GRAND AVE, SUITE 100, SURPRISE, AZ 85374-3548
(623) 584-0052
(623) 584-3706
Mailing address
PO BOX 61773, PHOENIX, AZ 85082-1773
(602) 682-6727
(602) 240-6177
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/30/2007
Last updated
10/22/2008
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