Premier Diagnostics PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4301067758 Issued in MI

Legal business name

PREMIER DIAGNOSTICS PC

Practice address

48492 Inveraray Rd
Canton, MI 48188

Phone

(734) 341-9969

NPI assigned

Mar 24, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mustafa Hashem, MD

Title

President

Phone

(743) 341-9969

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1861716508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48492 INVERARAY RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48188",
            "telephone_number": "734-341-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48492 INVERARAY RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48188",
            "telephone_number": "734-341-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DIAGNOSTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "HASHEM",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "743-341-9969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301067758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Canton, MI
• Providers in Canton, 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 Apr 1, 2010; 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.