Provider Demographics
NPI:1104376581
Name:EAST MICHIGAN CARDIOLOGY
Entity type:Organization
Organization Name:EAST MICHIGAN CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAWWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-245-6111
Mailing Address - Street 1:1031 SUNCREST DR
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1136
Mailing Address - Country:US
Mailing Address - Phone:810-245-6111
Mailing Address - Fax:810-538-0070
Practice Address - Street 1:1031 SUNCREST DR
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1136
Practice Address - Country:US
Practice Address - Phone:810-245-6111
Practice Address - Fax:810-538-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty