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MICHIGAN MEDICAL DIAGNOSTIC CENTER PC NPI 1093941908


NPI Information

NPI: 1093941908
Provider Name: MICHIGAN MEDICAL DIAGNOSTIC CENTER PC
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization

CLIA Number: 23D1038829

Address:
135 BARCLAY CIR
SUITE 109
ROCHESTER HILLS, MI
ZIP 48307
Phone: (248) 844-2980
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MICHIGAN MEDICAL DIAGNOSTIC CENTER PC is a thoracic surgery cardiothoracic vascular surgery in Rochester Hills, MI. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. MICHIGAN MEDICAL DIAGNOSTIC CENTER PC NPI is 1093941908. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

135 BARCLAY CIR
SUITE 109
ROCHESTER HILLS, MI
ZIP 48307-599
Phone: (248) 844-2980
Fax: (248) 844-2983

The provider's authorized official is Shahrokh Mansoori .
The authorized official title is Owner and has the following contact phone number (248) 844-2980.

The CLIA number assigned to this NPI record is 23D1038829 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2009 and was last updated on 1/9/2012.


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
1207R00000XInternal MedicineAM076045MICHIGANNo
2207R00000XInternal MedicineNM074148MICHIGANNo
3208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)SM038518MICHIGANYes

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: 5/5/2024

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