PREMIER VASCULAR ASSOCIATES, PLLC (NPI# 1972904951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972904951 |
| Entity Type | Organization |
| Organization Name | PREMIER VASCULAR ASSOCIATES, PLLC |
| Practice Address |
29519 Harper Ave Saint Clair Shores MI 48081-1275 |
| Practice Telephone | 5862705100 |
| Practice Fax Number | 5862705111 |
| Mailing Telephone | 5862705100 |
| Mailing Fax Number | 5862705111 |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2015-05-18 |
| Authorized Official Name | JIMMY C HAOUILOU (SOLE MEMBER) |
| Authorized Official Telephone | 5862705100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
4301084691 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
29519 HARPER AVE |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-1275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073659264 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 29519 Harper Ave, Saint Clair Shores, MI 48081-1275 | 2007-01-29 |
| 1114465044 | Professional Dietitian Services, LLC | Clinic/Center | 29519 Harper Ave, Saint Clair Shores, MI 48081-1275 | 2017-02-12 |
| 1285080697 | Amanda Alame | Dietitian, Registered | 29519 Harper Ave, Saint Clair Shores, MI 48081-1275 | 2016-05-04 |
| 1124455159 | Amer Alame Md PC | Surgery | 29519 Harper Ave, Saint Clair Shores, MI 48081-1275 | 2013-10-04 |
| 1972730067 | Alexandria Conley Glenn | Colon & Rectal Surgery | 29519 Harper Ave, Saint Clair Shores, MI 48081-1275 | 2009-06-16 |
| 1477709327 | Amer Mohamed Zeni | Surgery | 29519 Harper Ave, Saint Clair Shores, MI 48081-1275 | 2008-08-12 |
| 1063676286 | Jimmy Charbel Haouilou | Surgery | 29519 Harper Ave, Saint Clair Shores, MI 48081 | 2008-07-16 |
| 1093975542 | Amer M Alame | Colon & Rectal Surgery | 29519 Harper Ave, Saint Clair Shores, MI 48081-1275 | 2008-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922259217 | Arunkumar Baskara | Surgery | 29000 Little Mack Ave, Suite B, Saint Clair Shores, MI 48081-3018 | 2008-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437660057 | Iha Health Services Corporation | Surgery | 5333 Mcauley Dr Rm 4016, Ypsilanti, MI 48197-1001 | 2017-10-23 |
| 1760900138 | Integrated Vascular Vein Center of Michigan PC | Surgery | 600 Health Park Blvd Ste G, Grand Blanc, MI 48439-2558 | 2017-09-06 |
| 1770036147 | Joseph P. Elliott Jr. | Surgery | 3282 Woodview Lake Rd, West Bloomfield, MI 48323-3570 | 2016-08-02 |
| 1043676661 | Integrative Cardiovascular Health & Wellness | Surgery | 3250 Woods Way, Suite 9, Petoskey, MI 49770-7628 | 2016-01-12 |
| 1124411244 | Vascular Surgery Assoc, PC | Surgery | 1122 S Lapeer Rd Ste C, Lapeer, MI 48446-3387 | 2015-03-13 |
| 1013309988 | Bloomfield Vein & Vascular Pllc | Surgery | 43700 Woodward Ave Ste 207, Bloomfield Hills, MI 48302-5061 | 2015-03-02 |
| 1114288206 | Scott Bendix | Surgery | 28100 Grand River Ave Ste 200, Farmington Hills, MI 48336-5969 | 2012-06-05 |
| 1942561428 | Charles J Shanley Md PC | Surgery | 1001 Audubon Rd, Grosse Pointe, MI 48230-1406 | 2012-05-31 |
| 1508122995 | Robert J Cardwell Md Pllc | Surgery | 13312 Terry Dr, Shelby Township, MI 48315-5365 | 2012-04-10 |
| 1780919936 | Martin A V Tuma Md Vascular Surgery Pllc | Surgery | 22255 Greemfield Road #250, Southfield, MI 48075 | 2009-10-06 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.