Provider Demographics
NPI:1912169715
Name:THE CARDIAC INSTITUTE
Entity Type:Organization
Organization Name:THE CARDIAC INSTITUTE
Other - Org Name:MICHIGAN HEART & VASCULAR SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ZECHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-487-4000
Mailing Address - Street 1:560 W. MITCHELL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2212
Mailing Address - Country:US
Mailing Address - Phone:231-487-2490
Mailing Address - Fax:231-487-4615
Practice Address - Street 1:560 W. MITCHELL
Practice Address - Street 2:SUITE 400
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2212
Practice Address - Country:US
Practice Address - Phone:231-487-2490
Practice Address - Fax:231-487-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P61990Medicare PIN