Provider Demographics
NPI:1023492626
Name:PREMIER CARDIOVASCULAR CONSULTANTS PC
Entity type:Organization
Organization Name:PREMIER CARDIOVASCULAR CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAMMAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZMILY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-674-0034
Mailing Address - Street 1:2632 S ROCHESTER RD
Mailing Address - Street 2:#70306
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-7900
Mailing Address - Country:US
Mailing Address - Phone:248-480-0363
Mailing Address - Fax:248-480-0369
Practice Address - Street 1:1629 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3542
Practice Address - Country:US
Practice Address - Phone:248-480-0363
Practice Address - Fax:248-480-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301085958261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty