OrganizationActive
Blue Water Thoracic and Cardiovascular Surgery, PLC
NPI 1336322528 · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Port Huron, MI
Provider details
- NPI number
- 1336322528
- Entity type
- Organization
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Vernon Dencklau, Owner(810) 989-6113
- License
- 5101007542 (MI)
Specialties & taxonomies
- Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianPrimary208G00000XLicense 5101007542 (MI)
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1107 Stone St
Suite 1
Port Huron, MI 48060-3569
Phone: (810) 989-6113
Fax: (810) 989-6117
Approximate (ZIP-level) locationGet directions
Mailing address
1107 Stone St
Port Huron, MI 48060-3569
Registry dates
- Enumerated
- 2007-12-11
- Last updated
- 2008-08-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.