Provider Demographics
NPI:1265458756
Name:VALLEY CARDIOLOGY P C
Entity Type:Organization
Organization Name:VALLEY CARDIOLOGY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:UMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BADAMI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:989-497-9395
Mailing Address - Street 1:4884 BERL DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2802
Mailing Address - Country:US
Mailing Address - Phone:989-497-9395
Mailing Address - Fax:989-497-9599
Practice Address - Street 1:4884 BERL DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2802
Practice Address - Country:US
Practice Address - Phone:989-497-9395
Practice Address - Fax:989-497-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207RC0000X, 207RI0011X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI060G310410OtherBCBSM
MI060G310410OtherBCBSM
MI0M68150Medicare PIN