Organization
PREMIER VASCULAR ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY C HAOUILOU (SOLE MEMBER)
(586) 270-5100
Entity
Organization
Contact information
Practice address
29519 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1275
(586) 270-5100
(586) 270-5111
Mailing address
29519 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1275
(586) 270-5100
(586) 270-5111
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
4301084691
MI
Other
Enumeration date
09/10/2014
Last updated
05/18/2015
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