Individual
HIROSHI YAMASAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25195 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Mailing address
25195 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301066050
MI
207RI0011X
Interventional Cardiology Physician
4301066050
MI
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
4301066050
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060 500 8831
BLUE CROSS BLUE SHEILD
MI
05
—
4129307
—
MI
01
—
OH-26467011
MEDICARE ID
MI
Enumeration date
08/12/2005
Last updated
03/07/2023
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