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General NPI Number Information
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NPI Number | 1063000180
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Entity Type | Organization
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Legal Business Name | MICHIGAN HEART RHYTHM SPECIALISTS
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 4900 MERCURY DR STE 202
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City | DEARBORN
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State | MI
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Zip | 48126-2947
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Country | US
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Telephone | 602-319-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 MERCURY DR STE 202
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City | DEARBORN
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State | MI
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Zip | 48126-2947
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | DIANA EL MASRI
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Credential |
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Telephone | 248-215-0048
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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 |
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License Number State |
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