Healthcare Provider Details

I. General information

NPI: 1841505815
Provider Name (Legal Business Name): SENTINEL HEALTH STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19141 GREENFIELD RD
DETROIT MI
48235-6007
US

IV. Provider business mailing address

36745 DEQUINDRE RD
TROY MI
48083-2492
US

V. Phone/Fax

Practice location:
  • Phone: 313-421-9356
  • Fax:
Mailing address:
  • Phone: 313-421-9356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROB PETROPOULOS
Title or Position: OWNER
Credential:
Phone: 313-421-9356