Organization
NORTHWEST CARDIOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN J KERNER (PRESIDENT)
(248) 304-3200
Entity
Organization
Contact information
Practice address
26400 W 12 MILE RD, SUITE 120, SOUTHFIELD, MI 48034-1700
(248) 304-3200
(248) 208-9907
Mailing address
26400 W 12 MILE RD, SUITE 120, SOUTHFIELD, MI 48034-1700
(248) 304-3200
(248) 208-9907
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NK044996
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0606352841
BCBS PROVIDER NUMBER
MI
05
—
4840142
—
MI
01
—
NK044996
STATE LICENSE NUMBER
MI
Enumeration date
04/26/2007
Last updated
08/22/2020
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