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General NPI Number Information
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NPI Number | 1003298340
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Entity Type | Organization
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Legal Business Name | VASCULAR HEALTH CLINICS PLLC
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 2125 RIDGEWOOD DR
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City | MIDLAND
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State | MI
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Zip | 48642-5863
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Country | US
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Telephone | 989-254-6427
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Fax | 989-607-1314
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Provider Business Mailing Address
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Address Line | 2125 RIDGEWOOD DR
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City | MIDLAND
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State | MI
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Zip | 48642-5863
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Country | US
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Telephone | 989-254-6427
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Fax | 989-607-1314
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Authorized Official
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Title or Position | CEO
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Name | OMAR PURVES HAQQANI
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Credential | M.D.
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Telephone | 989-254-6427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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