Eastside Cardiovascular Medicine, P.C.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

EASTSIDE CARDIOVASCULAR MEDICINE, P.C.

Practice address

25195 Kelly Road
Suite a
Roseville, MI 48066-4909

Phone

(586) 775-4594

Fax

(586) 775-4506

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Vamshidhar D Guduguntia, M.D.

Title

President/Eastside Cardiovascular M

Phone

(586) 775-4594

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Eastside Cardiology PC Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sohail Akhtar Hassan, M.D.

  • Cardiovascular Disease Physician
  • Dearborn, MI
  • NPI 1225039563
  NPD
• Narayanan Vikraman, MD

  • Cardiovascular Disease Physician
  • Roseville, MI
  • NPI 1336141977
  NPD

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861493199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25195 KELLY RD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664909",
            "telephone_number": "586-775-4594",
            "fax_number": "586-775-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25195 KELLY ROAD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664909",
            "telephone_number": "586-775-4594",
            "fax_number": "586-775-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE CARDIOVASCULAR MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GUDUGUNTIA",
        "authorized_official_first_name": "VAMSHIDHAR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/EASTSIDE CARDIOVASCULAR M",
        "authorized_official_telephone_number": "586-775-4594",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "060E01111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Cardiology PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• East Area Family Physicians, P.C.
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• Eastland Diagnostic PC
• Jeffrey Waldemar Easton II, D.D.S.
• Eastside Cardiovascular Medicine
• Eastside Diagnostics LLC (Maxim MRI)
• Ecg Scanning & Medical Services Inc
• Latonya Nicole Edwards-Jones
• Robert David Edwards, MD
• Abdul R Effendi, MD

• Cardiovascular Disease Physician in Roseville, MI
• Providers in Roseville, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.