LIBERTY CARDIOLVASCULAR GROUP PLLC


Address: 5250 Auto Club Dr Ste 300l, Dearborn, MI 48126-2619
Phone: (313) 593-8988

LIBERTY CARDIOLVASCULAR GROUP PLLC (NPI# 1841719531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1841719531
Entity Type Organization
Organization Name LIBERTY CARDIOLVASCULAR GROUP PLLC
Practice Address 5250 Auto Club Dr Ste 300l
Dearborn
MI 48126-2619
Practice Telephone (313) 593-8988
Practice Fax Number 3139821541
Mailing Telephone 3135938988
Mailing Fax Number 3139821541
Enumeration Date 2017-09-13
Last Update Date 2017-09-13
Authorized Official Name PRUDY A CASSEL (MANAGER)
Authorized Official Telephone 3137249000
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) 4301056091 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI 4715912 05

Office Location

Street Address 5250 AUTO CLUB DR STE 300L
City DEARBORN
State MI
Zip Code 48126-2619

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1861972457 Laboratory Specialists of Michigan, LLC Clinical Medical Laboratory 13530 Michigan Ave Ste 240, Dearborn, MI 48126 2018-08-14
1528544806 Farah Osman Pharmacist 14715 Ford Rd, Dearborn, MI 48126 2018-07-19
1255821328 Loyal Pharmacy LLC Pharmacy 7118 Greenfield Rd St(b), Dearborn, MI 48126 2018-05-15
1952803900 Neetika Kesar Physical Therapist 15051, Ford Road, Dearborn, MI 48126 2018-03-06
1396247607 David Jerome Kurcz Physical Therapy Assistant 15051 Ford Road, Henry Ford Village, Dearborn, MI 48126 2018-03-02
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Taxonomy Information

Taxonomy Code 208G00000X
Grouping Allopathic & Osteopathic Physicians
Classification Thoracic Surgery (Cardiothoracic Vascular Surgery)

Taxonomy Definition

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043481419 Joseph S Bassett, Md, Plc Thoracic Surgery (Cardiothoracic Vascular Surgery) 18181 Oakwood Blvd, Suite # 102, Dearborn, MI 48124-5032 2008-03-13
1073580528 Joseph S Bassett Thoracic Surgery (Cardiothoracic Vascular Surgery) 18101 Oakwood Blvd, Suite 102, Dearborn, MI 48124-5032 2006-03-03
1750351383 Reza Dabir Thoracic Surgery (Cardiothoracic Vascular Surgery) 22060 Beech St Ste 300, Dearborn, MI 48124-2847 2006-01-25

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1710479191 United Surgical Associates Pllc Thoracic Surgery (Cardiothoracic Vascular Surgery) 2150 Association Dr, Okemos, MI 48864-4909 2018-06-01
1710411293 Abdul Hassan Thoracic Surgery (Cardiothoracic Vascular Surgery) 11 Chateaux Du Lac, Fenton, MI 48430 2017-04-12
1871982249 Michigan Heart Lung and Vein Surgery Thoracic Surgery (Cardiothoracic Vascular Surgery) 2757 Leonard Ne, Ste 200, Grand Rapids, MI 49525-5807 2015-01-22
1154767382 Michigan Thoracic Institute, PC Thoracic Surgery (Cardiothoracic Vascular Surgery) 6640 Kings Ct, West Bloomfield, MI 48322-2779 2013-05-15
1679815898 Hanna Park Thoracic Surgery (Cardiothoracic Vascular Surgery) 100 Michigan St Ne Rm 8830, Grand Rapids, MI 49503 2013-03-26
1760730469 Hurley Medical Center Thoracic Surgery (Cardiothoracic Vascular Surgery) 1125 S. Linden Road, Suite 700, Flint, MI 48532-4069 2012-08-28
1245588326 Bakri Kaakeh Thoracic Surgery (Cardiothoracic Vascular Surgery) 4701 Towne Centre Rd Ste 301, Saginaw, MI 48604-2800 2012-08-21
1447521554 Eduardo Arciniegas Thoracic Surgery (Cardiothoracic Vascular Surgery) 3236 Interlaken St, West Bloomfield, MI 48323-1824 2012-01-20
1629358650 Steven S. Demos Thoracic Surgery (Cardiothoracic Vascular Surgery) 3739 Highgate Rd, Norton Shores, MI 49441-5017 2011-08-22
1518283100 Jeffrey Thomas Perrapato Thoracic Surgery (Cardiothoracic Vascular Surgery) 6270 Lakewood Pointe Drive, Coloma, MI 49038 2010-04-08
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Competitor

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City DEARBORN
Zip Code 48126

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Dataset Information

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.

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