Provider Demographics
NPI:1578891735
Name:FLAT ROCK CARDIOLOGY PC
Entity Type:Organization
Organization Name:FLAT ROCK CARDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:KALATA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-675-8428
Mailing Address - Street 1:2764 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29100 GATEWAY BOULEVARD
Practice Address - Street 2:SUITE 300
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134
Practice Address - Country:US
Practice Address - Phone:734-379-0781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty