Provider Demographics
NPI:1316083116
Name:NONINVASIVE VASCULAR TESTING INC
Entity type:Organization
Organization Name:NONINVASIVE VASCULAR TESTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:WOLK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-434-4200
Mailing Address - Street 1:5301 MCAULEY DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1051
Mailing Address - Country:US
Mailing Address - Phone:734-434-4200
Mailing Address - Fax:
Practice Address - Street 1:5325 ELLIOTT DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8633
Practice Address - Country:US
Practice Address - Phone:734-434-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI304234OtherJACKSON HEALTH PLAN
MI023635OtherMIDWEST HEALTH PLAN
MI0988819OtherHEALTHPLUS OF MI
MI304234OtherMIDMICHIGAN HEALTH PLAN
MIOP810047OtherM-CARE
MI0H11110OtherBLUE CROSS BLUE SHIELD
MI38245OtherCAPE HEALTH
MI13753OtherPRIORITY HEALTH
MI127982OtherCARE CHOICES
MICB2637OtherRAILROAD MEDICARE
MI38245OtherCAPE HEALTH
MI13753OtherPRIORITY HEALTH
MI0988819OtherHEALTHPLUS OF MI
MI0N13810Medicare ID - Type Unspecified