Provider Demographics
NPI:1912091562
Name:HURON VALLEY HEART, P.C.
Entity type:Organization
Organization Name:HURON VALLEY HEART, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:Z
Authorized Official - Last Name:KARABAJAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-685-9780
Mailing Address - Street 1:414 UNION ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1989
Mailing Address - Country:US
Mailing Address - Phone:248-685-9780
Mailing Address - Fax:
Practice Address - Street 1:414 UNION ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1989
Practice Address - Country:US
Practice Address - Phone:248-685-9780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMK011367207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00061832OtherRAILROAD MEDICARE
MI0656310564OtherBCBS OF MICHIGAN
0F33901OtherBCBS GROUP PIN
MI114578887Medicaid
MI0656310564OtherBCBS OF MICHIGAN
MIP15910001Medicare PIN