Provider Demographics
NPI:1104061225
Name:TOTAL HEART CARE, PC
Entity type:Organization
Organization Name:TOTAL HEART CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-649-0702
Mailing Address - Street 1:1559 W BIG BEAVER RD
Mailing Address - Street 2:BLDG E
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3525
Mailing Address - Country:US
Mailing Address - Phone:248-649-0702
Mailing Address - Fax:248-649-9770
Practice Address - Street 1:1559 W BIG BEAVER RD
Practice Address - Street 2:BLDG E
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3525
Practice Address - Country:US
Practice Address - Phone:248-649-0702
Practice Address - Fax:248-649-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI032739207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0639837OtherBLUE CARE NETWORK
0639837OtherBLUE CROSS BLUE SHIELD
MI2962960Medicaid
0639837OtherBLUE CARE NETWORK