Provider Demographics
NPI:1639644305
Name:METROPOLITAN CARDIOVASCULAR
Entity Type:Organization
Organization Name:METROPOLITAN CARDIOVASCULAR
Other - Org Name:METROPOLITAN CARDIOVASCULAR
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMANJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-333-8913
Mailing Address - Street 1:PO BOX 40202
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-0202
Mailing Address - Country:US
Mailing Address - Phone:248-331-2715
Mailing Address - Fax:248-450-5580
Practice Address - Street 1:28667 BAYBERRY CT E
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3869
Practice Address - Country:US
Practice Address - Phone:248-331-2715
Practice Address - Fax:248-450-5580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1992933352OtherCOMMERCIAL INSURANCE
MI1992933352Medicaid