Organization
K HEART & VASCULAR INSTITUTE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINIVAS KONERU M.D. (PHYSICIAN)
(586) 722-7440
Entity
Organization
Contact information
Practice address
33376 DEQUINDRE ROAD, STERLING HEIGHTS, MI 48310-5966
(586) 722-7440
(586) 722-7675
Mailing address
33376 DEQUINDRE ROAD, STERLING HEIGHTS, MI 48310-5966
(586) 722-7440
(586) 722-7675
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501427
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
—
0E05972
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
05
—
1477599587
—
MI
Enumeration date
10/07/2016
Last updated
02/26/2019
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