Healthcare Provider Details

I. General information

NPI: 1093351009
Provider Name (Legal Business Name): ADVANCED CARDIOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 BARCLAY CIR
ROCHESTER HILLS MI
48307-5804
US

IV. Provider business mailing address

645 BARCLAY CIR
ROCHESTER HILLS MI
48307-5804
US

V. Phone/Fax

Practice location:
  • Phone: 248-844-1010
  • Fax: 248-844-9089
Mailing address:
  • Phone: 248-844-1010
  • Fax: 248-844-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUDY L HARDER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 248-844-1010