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General NPI Number Information
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NPI Number | 1144416264
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Entity Type | Organization
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Legal Business Name | HEALTHY HEART CARDIOLOGY, PLC
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 3181 PRAIRIE ST SW SUITE 112
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City | GRANDVILLE
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State | MI
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Zip | 49418-2097
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Country | US
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Telephone | 616-291-6952
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Fax | 866-966-9677
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Provider Business Mailing Address
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Address Line | 3181 PRAIRIE ST SW SUITE 112
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City | GRANDVILLE
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State | MI
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Zip | 49418-2097
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Country | US
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Telephone | 616-291-6952
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Fax | 866-966-9677
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Authorized Official
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Title or Position | OWNER
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Name | SANDEEP KHURANA
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Credential | MD
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Telephone | 616-291-6952
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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 | 4301053818
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License Number State | MI
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