Healthcare Provider Details

I. General information

NPI: 1811311418
Provider Name (Legal Business Name): CRV IMAGING CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26711 WOODWARD AVE SUITE LL-B
HUNTINGTON WOODS MI
48070-1333
US

IV. Provider business mailing address

26711 WOODWARD AVE SUITE LL-B
HUNTINGTON WOODS MI
48070-1333
US

V. Phone/Fax

Practice location:
  • Phone: 248-268-3730
  • Fax: 248-544-2727
Mailing address:
  • Phone: 248-268-3730
  • Fax: 248-544-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number16211
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number16211
License Number StateMI

VIII. Authorized Official

Name: CINDY VALENTINE
Title or Position: PRESIDENT
Credential:
Phone: 248-565-6567