Healthcare Provider Details

I. General information

NPI: 1144305673
Provider Name (Legal Business Name): CHARLES G. ARTINIAN MD FACC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 WRIGHT AVE
SHEPHERD MI
48883
US

IV. Provider business mailing address

318 WRIGHT AVE
SHEPHERD MI
48883
US

V. Phone/Fax

Practice location:
  • Phone: 989-828-4700
  • Fax: 989-282-6209
Mailing address:
  • Phone: 989-828-4700
  • Fax: 989-282-6209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301029369
License Number StateMI

VIII. Authorized Official

Name: DR. CHARLES G ARTINIAN
Title or Position: OWNER
Credential: MD
Phone: 989-828-4700