Provider Demographics
NPI:1437127297
Name:CARDIOLOGY INSTITUTE OF MICHIGAN, PLLC
Entity Type:Organization
Organization Name:CARDIOLOGY INSTITUTE OF MICHIGAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAUBINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-762-1844
Mailing Address - Street 1:5100 GATEWAY CENTRE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3927
Mailing Address - Country:US
Mailing Address - Phone:810-733-6480
Mailing Address - Fax:810-733-6483
Practice Address - Street 1:5100 GATEWAY CENTRE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3927
Practice Address - Country:US
Practice Address - Phone:810-733-6480
Practice Address - Fax:810-733-6483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N87110Medicare PIN