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General NPI Number Information
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NPI Number | 1003166075
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Entity Type | Organization
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Legal Business Name | HEART & VASCULAR INSTITUTE OF MI P.C.
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 1075 SUNCREST DR SUITE C
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City | LAPEER
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State | MI
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Zip | 48446-4403
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Country | US
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Telephone | 810-667-7333
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Fax | 810-660-8133
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Provider Business Mailing Address
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Address Line | 1075 SUNCREST DR SUITE C
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City | LAPEER
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State | MI
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Zip | 48446-4403
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Country | US
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Telephone | 810-667-7333
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Fax | 810-660-8133
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAJED NOUNOU
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Credential | M.D.
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Telephone | 810-667-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301091738
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License Number State | MI
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