PREMIER CARDIOVASCULAR SPECIALISTS PC NPI 1083854095

NPI Information

NPI: 1083854095
Provider Name: PREMIER CARDIOVASCULAR SPECIALISTS PC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 23D1056364

Address:
20200 OUTER DR
DEARBORN, MI
ZIP 48124
Phone: (313) 624-8417
Get Directions

PREMIER CARDIOVASCULAR SPECIALISTS PC is a cardiovascular disease internal medicine in Dearborn, MI. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. PREMIER CARDIOVASCULAR SPECIALISTS PC NPI is 1083854095. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

20200 OUTER DR
DEARBORN, MI
ZIP 48124-634
Phone: (313) 624-8417
Fax: (313) 357-7074

The provider's authorized official is Samer Salka .
The authorized official title is President and has the following contact phone number (734) 459-7444.

The CLIA number assigned to this NPI record is 23D1056364 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/3/2009 and was last updated on 12/17/2021.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	SS051535	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1811956139	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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