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1740283324

NPI Code Detail

MEDICARE: ADVANCED RADIOLOGY SERVICES, P.C.

MEDICARE: ADVANCED RADIOLOGY SERVICES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	502389	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CN1920	OTHER	MI	RAILROAD MEDICARE
3	0N99420	OTHER	MI	MEDICARE NP GROUP
4	0N78710	OTHER	MI	MEDICARE PA GROUP
6	CN1919	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P63018	OTHER	MI	BLUE CARE NETWORK
5	500D114350	OTHER	MI	BLUE CROSS BLUE SHIELD NP
7	300D110870	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1740283324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED RADIOLOGY SERVICES, P.C.

Provider Business Mailing Address
First Line	:	3264 N EVERGREEN DR NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-9746
Country	:	US
Telephone Number	:	616-363-7272
Fax Number	:	616-363-7290

Provider Business Practice Location Address
First Line	:	3264 N EVERGREEN DR NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-9746
Country	:	US
Telephone Number	:	616-363-7272
Fax Number	:	616-363-7290

Authorized Official
Title or Position	:	CAO
Name	:	MRS. RITA WESTPHAL
Credential	:
Telephone Number	:	616-363-7339

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	06/12/2019

Similar Medicare Providers

1720081649 — JAY A HAROLDS MD
Practice Location Address:

3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
49525-9746

Practice Phone: 616-363-7339
Practice Fax: 616-361-5828

1497752448 — DR. CHARLES EDWARD SWALLOW M.D.
Practice Location Address:

3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
49525-9746

Practice Phone: 616-363-7339
Practice Fax: 616-361-5828

1326049727 — DR. DANIEL D. DO-DAI M.D.
Practice Location Address:

3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
49525-9746

Practice Phone: 616-363-7272
Practice Fax: 616-361-5828

1184619637 — ALAN B ENGEL MD
Practice Location Address:

3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
49525-9746

Practice Phone: 616-363-7272
Practice Fax: 616-361-5828

1467449199 — LEWIS A JONES M.D.
Practice Location Address:

3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
49525-9746

Practice Phone: 616-363-7339
Practice Fax: 616-361-5828

1972593101 — BENJAMIN J POMERANTZ MD
Practice Location Address:

3264 N EVERGREEN DR NE
GRAND RAPIDS, MI
49525-9746

Practice Phone: 616-363-7272
Practice Fax: 616-361-5828

Directions to “ADVANCED RADIOLOGY SERVICES, P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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