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PEDIATRIC CARDIOLOGY OF SOUTHEASTREN MICHIGAN PLLC NPI 1386204022


NPI Information

NPI: 1386204022
Provider Name: PEDIATRIC CARDIOLOGY OF SOUTHEASTREN MICHIGAN, PLLC
Classification: Pediatrics - 2080P0202X
Entity Type: Organization

Specialization: Pediatric Cardiology

Address:
43380 WOODWARD AVE STE 105
BLOOMFIELD HILLS, MI
ZIP 48302
Phone: (248) 335-8500
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PEDIATRIC CARDIOLOGY OF SOUTHEASTREN MICHIGAN, PLLC is a pediatric cardiology pediatrics in Bloomfield Hills, MI. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. PEDIATRIC CARDIOLOGY OF SOUTHEASTREN MICHIGAN, PLLC NPI is 1386204022. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

43380 WOODWARD AVE STE 105
BLOOMFIELD HILLS, MI
ZIP 48302-050
Phone: (248) 335-8500
Fax: (248) 940-2949

The provider's authorized official is Rossitza Prokopieva Pironkova .
The authorized official title is Owner and has the following contact phone number (248) 335-8500.

The enumeration date for this NPI number is 6/14/2019 and was last updated on 6/14/2019.


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
12080P0202XPediatricsPediatric CardiologyYes

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
11316244304MEDICAIDMICHIGAN

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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