Organization
CARDIOVASCULAR INSTITUTE OF MICHIGAN, P.C.
Active
Organization
CARDIOVASCULAR INSTITUTE OF MICHIGAN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMAD K AJJOUR M.D. (ADMINISTRATOR)
(586) 776-8877
Entity
Organization
Contact information
Practice address
18303 E 10 MILE RD, SUITE 100, ROSEVILLE, MI 48066-4988
(586) 776-8877
(586) 776-3092
Mailing address
18303 E 10 MILE RD, SUITE 100, ROSEVILLE, MI 48066-4988
(586) 776-8877
(586) 776-3092
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E01050
BCBS GROUP
MI
01
—
CD6196
RAILROAD MEDICARE
MI
01
—
M018365
CHAMPUS GROUP
MI
Enumeration date
07/03/2006
Last updated
03/21/2011
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