Organization
GREAT LAKES HEART & VASCULAR INSTITUTE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS K POW M.D. (PRESIDENT)
(269) 985-1000
Entity
Organization
Contact information
Practice address
3950 HOLLYWOOD RD, SUITE 110, SAINT JOSEPH, MI 49085-9151
(269) 985-1000
(269) 983-1627
Mailing address
3950 HOLLYWOOD RD, SUITE 110, SAINT JOSEPH, MI 49085-9151
(269) 985-1000
(269) 983-1627
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
TP054928
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3444708
—
MI
05
—
4176414
—
MI
05
—
4176450
—
MI
05
—
4176497
—
MI
05
—
4718520
—
MI
05
—
4751365
—
MI
Enumeration date
10/26/2006
Last updated
04/15/2015
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