Healthcare Provider Details

I. General information

NPI: 1528086808
Provider Name (Legal Business Name): RADIATION ONCOLOGY ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W GREENLAWN AVE
LANSING MI
48910-2819
US

IV. Provider business mailing address

3621 S. STATE ST. 700 KMS, RM 519, RAD ONC
ANN ARBOR MI
48108-1633
US

V. Phone/Fax

Practice location:
  • Phone: 517-367-5070
  • Fax: 517-372-6464
Mailing address:
  • Phone: 734-647-5170
  • Fax: 734-615-5851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. MARC A. HALMAN
Title or Position: SECRETARY DIRECTOR
Credential:
Phone: 734-936-4302