Provider Demographics
NPI:1285032458
Name:ALKIEK CARDIOLOGY PC
Entity Type:Organization
Organization Name:ALKIEK CARDIOLOGY PC
Other - Org Name:GENESEE CARDIOLOGY CLINIC PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RADWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALKIEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-771-4818
Mailing Address - Street 1:10751 S SAGINAW ST
Mailing Address - Street 2:STE D
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8169
Mailing Address - Country:US
Mailing Address - Phone:810-771-4818
Mailing Address - Fax:810-519-4842
Practice Address - Street 1:5097 MILLER RD
Practice Address - Street 2:STE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1043
Practice Address - Country:US
Practice Address - Phone:810-265-7034
Practice Address - Fax:810-519-4842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty