Premier Cardiovascular Specialists PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

SS051535 Issued in MI

Legal business name

PREMIER CARDIOVASCULAR SPECIALISTS PC

Practice address

20200 Outer Dr
Dearborn, MI 48124-2634

Phone

(313) 624-8417

Fax

(313) 357-7074

NPI assigned

Mar 3, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samer Salka, M.D.

Title

President

Phone

(734) 459-7444

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1083854095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20200 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242634",
            "telephone_number": "313-624-8417",
            "fax_number": "313-357-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20200 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242634",
            "telephone_number": "313-624-8417",
            "fax_number": "313-357-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARDIOVASCULAR SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "SALKA",
        "authorized_official_first_name": "SAMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-459-7444",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "SS051535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811956139",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.