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General NPI Number Information
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NPI Number | 1477845824
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Entity Type | Organization
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Legal Business Name | EHK ENDOVASCULAR PLLC
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 5250 AUTO CLUB DR STE 170
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City | DEARBORN
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State | MI
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Zip | 48126-2619
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Country | US
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Telephone | 313-359-8300
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Fax | 313-359-8305
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Provider Business Mailing Address
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Address Line | 5250 AUTO CLUB DR STE 170
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City | DEARBORN
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State | MI
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Zip | 48126-2619
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Country | US
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Telephone | 313-359-8300
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Fax | 313-359-8036
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELIAS H KASSAB
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Credential | M.D.
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Telephone | 313-359-8300
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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 | 4301047006
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 4301047006
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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