Provider Demographics
NPI:1366847238
Name:MIDWEST CARDIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:MIDWEST CARDIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPASIFAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-261-9211
Mailing Address - Street 1:30626 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1870
Mailing Address - Country:US
Mailing Address - Phone:734-261-9211
Mailing Address - Fax:734-261-8537
Practice Address - Street 1:30626 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1870
Practice Address - Country:US
Practice Address - Phone:734-261-9211
Practice Address - Fax:734-261-8537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006579174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty