Provider Demographics
NPI:1063588382
Name:ARRHYTHMIA CENTER OF SOUTHWEST MICHIGAN
Entity type:Organization
Organization Name:ARRHYTHMIA CENTER OF SOUTHWEST MICHIGAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRUBELICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-375-4214
Mailing Address - Street 1:7901 12TH STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024
Mailing Address - Country:US
Mailing Address - Phone:269-375-4214
Mailing Address - Fax:888-580-2740
Practice Address - Street 1:7901 12TH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024
Practice Address - Country:US
Practice Address - Phone:269-375-4214
Practice Address - Fax:888-580-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI431060601207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104756924Medicaid
E832161Medicare UPIN
MI104756924Medicaid