| Greater Flint Sports Medicine Center Pc | |
|
861 Health Park Blvd, Grand Blanc, MI 48439 | |
| (810) 953-0500 | |
| (810) 953-0031 |
| Full Name | Greater Flint Sports Medicine Center Pc |
|---|---|
| Type | Facility |
| Speciality | Orthopaedic Surgery |
| Location | 861 Health Park Blvd, Grand Blanc, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265459150 | NPI | - | NPPES |
| 30610 | Other | MI | BLUE CROSS PHYS THERAPY |
| 200B547370 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (Michigan) | Secondary |
| 207X00000X | Orthopaedic Surgery | (* (Not Available)) | Primary |
| Provider Name | Tudor R Tien |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033101225 PECOS PAC ID: 1759350432 Enrollment ID: I20040930000412 |
| Provider Name | James Heming |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992734586 PECOS PAC ID: 5890767446 Enrollment ID: I20050321000422 |
| Provider Name | Todd A Sandrock |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235131541 PECOS PAC ID: 2264535103 Enrollment ID: I20080613000578 |
| Provider Name | Matthew Carl Sardelli |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992992705 PECOS PAC ID: 3779636816 Enrollment ID: I20100916000650 |
| Provider Name | Amir Kianoosh M Fallahi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801053996 PECOS PAC ID: 2264681733 Enrollment ID: I20120927000775 |
| Provider Name | Matthew J Marquart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164610960 PECOS PAC ID: 8426227372 Enrollment ID: I20121018000314 |
| Provider Name | Ryan Allen Nelson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093009979 PECOS PAC ID: 8820318041 Enrollment ID: I20170519001831 |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Flint Sports Medicine Center Pc 861 Health Park Blvd, Grand Blanc, MI 48439-7383 Ph: (810) 953-0500 | Greater Flint Sports Medicine Center Pc 861 Health Park Blvd, Grand Blanc, MI 48439 Ph: (810) 953-0500 |