| 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  |