Provider Demographics
NPI:1053368233
Name:CARDIOVASCULAR CONSULTANTS PC
Entity type:Organization
Organization Name:CARDIOVASCULAR CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KAZZIHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-698-1200
Mailing Address - Street 1:37771 SCHOENHERR RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-2302
Mailing Address - Country:US
Mailing Address - Phone:586-698-1200
Mailing Address - Fax:586-978-1323
Practice Address - Street 1:37771 SCHOENHERR RD
Practice Address - Street 2:SUITE 103
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-2302
Practice Address - Country:US
Practice Address - Phone:586-698-1200
Practice Address - Fax:586-274-2481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E06345Medicare ID - Type UnspecifiedMEDICARE GROUP ID