Provider Demographics
NPI:1912073776
Name:CARDIOTHORACIC ASSOCIATES, P.L.C.
Entity Type:Organization
Organization Name:CARDIOTHORACIC ASSOCIATES, P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANUP
Authorized Official - Middle Name:
Authorized Official - Last Name:SUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-733-2481
Mailing Address - Street 1:G3346 BEECHER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3649
Mailing Address - Country:US
Mailing Address - Phone:810-733-2481
Mailing Address - Fax:810-733-2482
Practice Address - Street 1:G3346 BEECHER RD
Practice Address - Street 2:SUITE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3649
Practice Address - Country:US
Practice Address - Phone:810-733-2481
Practice Address - Fax:810-733-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIB6017W208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4502842Medicaid
MI1805720Medicaid
MI4502842Medicaid
MI1805720Medicaid
MI0M36940Medicare ID - Type Unspecified
MIB41615Medicare UPIN