Provider Demographics
NPI:1043676661
Name:INTEGRATIVE CARDIOVASCULAR HEALTH & WELLNESS
Entity Type:Organization
Organization Name:INTEGRATIVE CARDIOVASCULAR HEALTH & WELLNESS
Other - Org Name:4 SEASONS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZMERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-881-9700
Mailing Address - Street 1:3280 WOODS WAY UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8105
Mailing Address - Country:US
Mailing Address - Phone:231-348-3800
Mailing Address - Fax:231-348-3804
Practice Address - Street 1:3290 WOODS WAY
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8694
Practice Address - Country:US
Practice Address - Phone:231-348-3800
Practice Address - Fax:231-348-3804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2083P0901X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty