Provider Demographics
NPI:1043618143
Name:CARDIOLOGY CARE CONSULTANTS PLLC
Entity Type:Organization
Organization Name:CARDIOLOGY CARE CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-225-4464
Mailing Address - Street 1:26711 WOODWARD AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1369
Mailing Address - Country:US
Mailing Address - Phone:248-225-4464
Mailing Address - Fax:
Practice Address - Street 1:26711 WOODWARD AVE STE 307
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1369
Practice Address - Country:US
Practice Address - Phone:248-225-4464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMB047506207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty