Provider Demographics
NPI:1467633412
Name:GARDEN CITY MEDICAL CENTER, P.C.
Entity Type:Organization
Organization Name:GARDEN CITY MEDICAL CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THIMMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-522-3770
Mailing Address - Street 1:2020 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2961
Mailing Address - Country:US
Mailing Address - Phone:734-522-3770
Mailing Address - Fax:734-522-6114
Practice Address - Street 1:2020 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2961
Practice Address - Country:US
Practice Address - Phone:734-522-3770
Practice Address - Fax:734-522-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherCOMM INSURANCE/3RD PARTY
MI0M54680Medicare UPIN