Healthcare Provider Details

I. General information

NPI: 1811104102
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF SOUTHWEST MICHIGAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 N CATAMOUNT TRL NE
ADA MI
49301-8653
US

IV. Provider business mailing address

4710 N CATAMOUNT TRL NE
ADA MI
49301-8653
US

V. Phone/Fax

Practice location:
  • Phone: 616-365-0650
  • Fax: 616-365-0659
Mailing address:
  • Phone: 616-365-0650
  • Fax: 616-365-0659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ROBERT BRUCE HILLS
Title or Position: PRESIDENT
Credential: D.O.
Phone: 616-365-0650