Provider Demographics
NPI:1154498467
Name:CARDIAC IMAGER PLLC
Entity Type:Organization
Organization Name:CARDIAC IMAGER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MESSANA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-498-4053
Mailing Address - Street 1:2809 EMERALD PARK
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603
Mailing Address - Country:US
Mailing Address - Phone:989-498-4053
Mailing Address - Fax:989-498-4052
Practice Address - Street 1:2809 EMERALD PARK
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603
Practice Address - Country:US
Practice Address - Phone:989-498-4053
Practice Address - Fax:989-498-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL7725202085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00900798OtherRR MEDICARE
MI4926274Medicaid
MI3157900774OtherBCBS OF MI
H30579Medicare UPIN
MIM21440050Medicare ID - Type Unspecified