Organization
METRO CARDIOLOGY GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANULLAH KHAN PATHAN MD (PRESIDENT)
(618) 239-3356
Entity
Organization
Contact information
Practice address
4600 MEMORIAL DR STE 420, BELLEVILLE, IL 62226-5366
(618) 239-3356
(618) 239-3359
Mailing address
4600 MEMORIAL DR, MEDICAL CENTER 2 STE 420, BELLEVILLE, IL 62226-5366
(618) 239-3356
(618) 239-3359
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060909
—
IL
01
—
08200472
BCBS
IL
01
—
0938287001
CIGNA
—
01
—
100789
BCBS
MO
01
—
101463
HEALTHLINK
—
01
—
140491
PHCS
—
01
—
146897XX
PREFERRED CARE
—
01
—
1495152
BCBS
PA
01
—
2102754
AETNA
—
01
—
2507179
UHC
—
01
—
7661
GHP CMR
—
01
—
CA5095
RR MEDICARE
IL
01
—
D14712
MERCY HEALTH PLAN
—
Enumeration date
07/10/2006
Last updated
06/22/2010
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