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General NPI Number Information
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NPI Number | 1669984480
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Entity Type | Organization
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Legal Business Name | ADVANCED CARDIAC & VASCULAR CENTERS FOR AMPUTATION PREVENTION PLC
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 1525 E BELTLINE AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-4598
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Country | US
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Telephone | 616-447-8220
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 E BELTLINE AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-4598
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Country | US
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Telephone | 616-447-8220
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FADI A SAAB
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Credential | MD
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Telephone | 616-447-8220
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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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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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