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Organization
EHK ENDOVASCULAR PLLC
Active
Organization
EHK ENDOVASCULAR PLLC
Active
Other names
EHK Endovascular PLLC, Michigan Outpatient Vascular Institute LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAS H KASSAB M.D. (OWNER)
(313) 359-8300
Entity
Organization
Contact information
Practice address
5250 AUTO CLUB DR STE 170, DEARBORN, MI 48126-2619
(313) 359-8300
(313) 359-8305
Mailing address
5250 AUTO CLUB DR STE 170, DEARBORN, MI 48126-2619
(313) 359-8300
(313) 359-8036
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301047006
MI
207RI0011X
Interventional Cardiology Physician
4301047006
MI
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H27482
BCN GROUP PIN
MI
01
—
DT5132
RAILROAD MEDICARE GP PTAN
MI
Enumeration date
05/04/2011
Last updated
01/12/2024
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