Healthcare Provider Details

I. General information

NPI: 1942574033
Provider Name (Legal Business Name): RADIATION ONCOLOGY ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 WEST GREENLAWN AVENUE SUITE 100
LANSING MI
48910-2819
US

IV. Provider business mailing address

3621 S STATE ST 700 KMS PLACE
ANN ARBOR MI
48108
US

V. Phone/Fax

Practice location:
  • Phone: 517-367-5070
  • Fax:
Mailing address:
  • Phone: 734-936-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: DAVID A SPAHLINGER
Title or Position: EXEC MEDICAL DIRECTOR FACULTY GRP
Credential:
Phone: 734-936-3568