Provider Demographics
NPI:1447250022
Name:PHYSICIANS ELECTROCARDIOGRAMS INTERPRETATIONS OF SPRINGFIELD INC
Entity type:Organization
Organization Name:PHYSICIANS ELECTROCARDIOGRAMS INTERPRETATIONS OF SPRINGFIELD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILHELM
Authorized Official - Middle Name:H
Authorized Official - Last Name:KALWEIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-390-5000
Mailing Address - Street 1:1343 N FOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1422
Mailing Address - Country:US
Mailing Address - Phone:937-390-5000
Mailing Address - Fax:
Practice Address - Street 1:1343 N FOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1422
Practice Address - Country:US
Practice Address - Phone:937-390-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055163207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0697983Medicaid
OH9925111Medicare ID - Type Unspecified