Provider Demographics
NPI:1043609407
Name:TOP CARDIOLOGY ASSOCIATES OF MICHIGAN PLLC
Entity type:Organization
Organization Name:TOP CARDIOLOGY ASSOCIATES OF MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:GUNATEET
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSWAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-228-2518
Mailing Address - Street 1:43211 DALCOMA DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6309
Mailing Address - Country:US
Mailing Address - Phone:586-228-2518
Mailing Address - Fax:586-228-2517
Practice Address - Street 1:43211 DALCOMA DR
Practice Address - Street 2:SUITE 9
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6309
Practice Address - Country:US
Practice Address - Phone:586-228-2518
Practice Address - Fax:586-228-2517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073226207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4353920Medicaid
MI4353920Medicaid