Provider Demographics
NPI:1841418340
Name:FLINT CARDIOVASCULAR IMAGING PC
Entity Type:Organization
Organization Name:FLINT CARDIOVASCULAR IMAGING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:AQEL
Authorized Official - Last Name:ELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-720-3370
Mailing Address - Street 1:4455 TOWN CENTER PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3614
Mailing Address - Country:US
Mailing Address - Phone:810-720-3369
Mailing Address - Fax:810-963-0345
Practice Address - Street 1:4455 TOWN CENTER PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3614
Practice Address - Country:US
Practice Address - Phone:810-720-3369
Practice Address - Fax:810-963-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty