GREAT LAKES CARDIOVASCULAR & THORACIC SURGEONS NPI 1114055662

NPI Information

GREAT LAKES CARDIOVASCULAR & THORACIC SURGEONS is a specialist in Dearborn, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GREAT LAKES CARDIOVASCULAR & THORACIC SURGEONS NPI is 1114055662. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17000 HUBBARD DR
SUITE 100
DEARBORN, MI
ZIP 48126-258
Phone: (313) 441-1441
Fax: (313) 441-2071

The provider's authorized official is Timothy L Sell .
The authorized official title is Equal Partner and has the following contact phone number (313) 441-1441.

The CLIA number assigned to this NPI record is 23D2028847 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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