Provider Demographics
NPI:1386108835
Name:DOWNRIVER VASCULAR ASSOCIATES PLC
Entity type:Organization
Organization Name:DOWNRIVER VASCULAR ASSOCIATES PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDHEER
Authorized Official - Middle Name:
Authorized Official - Last Name:UMMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-429-3211
Mailing Address - Street 1:16507 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2503
Mailing Address - Country:US
Mailing Address - Phone:313-429-3211
Mailing Address - Fax:313-429-3212
Practice Address - Street 1:16507 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2503
Practice Address - Country:US
Practice Address - Phone:313-429-3211
Practice Address - Fax:313-429-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty