Provider Demographics
NPI:1679889539
Name:CLINICAL CARDIOVASCULAR CARE PC
Entity Type:Organization
Organization Name:CLINICAL CARDIOVASCULAR CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NIZAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HABHAB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-634-3361
Mailing Address - Street 1:25516 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25516 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3022
Practice Address - Country:US
Practice Address - Phone:734-634-3361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty