Provider Demographics
NPI:1831520212
Name:ACCESS AND VASCULAR CARE
Entity type:Organization
Organization Name:ACCESS AND VASCULAR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-979-5446
Mailing Address - Street 1:10861 W 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1745
Mailing Address - Country:US
Mailing Address - Phone:248-268-1135
Mailing Address - Fax:248-268-1191
Practice Address - Street 1:10861 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1745
Practice Address - Country:US
Practice Address - Phone:248-268-1135
Practice Address - Fax:248-268-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINS0346702086S0129X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4661535OtherAETNA
7588998OtherCIGNA
B48525OtherHAP
NS034670OtherBCBSM
NS034670OtherBCN
NS034670OtherBCN
4661535OtherAETNA