EASTLAKE CARDIOVASCULAR PC NPI 1982657474

NPI Information

  • NPI: 1982657474
  • Provider Name: EASTLAKE CARDIOVASCULAR PC
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Organization
  • CLIA Number: 23D2110027
  • Address: 24211 LITTLE MACK AVE
    ST CLAIR SHORES, MI
    ZIP 48080
  • Phone: (586) 498-0440

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NPI Details

EASTLAKE CARDIOVASCULAR PC is a cardiovascular disease internal medicine in St Clair Shores, 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. EASTLAKE CARDIOVASCULAR PC NPI is 1982657474. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

24211 LITTLE MACK AVE
ST CLAIR SHORES, MI
ZIP 48080-190
Phone: (586) 498-0440
Fax: (586) 498-0401

The provider's authorized official is George B Ghanem .
The authorized official title is President and has the following contact phone number (586) 498-0440.

The CLIA number assigned to this NPI record is 23D2110027 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 12/1/2020.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular DiseaseMICHIGANYes

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: 11/21/2025

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