Healthcare Provider Details

I. General information

NPI: 1932547916
Provider Name (Legal Business Name): CARDIOVASCULAR CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 06/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 LIVERNOIS RD
TROY MI
48083-1603
US

IV. Provider business mailing address

2221 LIVERNOIS RD
TROY MI
48083-1603
US

V. Phone/Fax

Practice location:
  • Phone: 248-250-9474
  • Fax: 248-250-9483
Mailing address:
  • Phone: 248-250-9474
  • Fax: 248-250-9483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number4301088388
License Number StateMI

VIII. Authorized Official

Name: SABA DARDA
Title or Position: OWNER
Credential: M.D.
Phone: 248-250-9474