Healthcare Provider Details

I. General information

NPI: 1568656932
Provider Name (Legal Business Name): CEDAR STRAITS MEDICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OSBORN BLVD
SAULT SAINTE MARIE MI
49783-1822
US

IV. Provider business mailing address

PO BOX 3079
ANN ARBOR MI
48106-3079
US

V. Phone/Fax

Practice location:
  • Phone: 800-764-7297
  • Fax: 734-677-7407
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RALPH J DUMAN
Title or Position: OWNER
Credential: MD
Phone: 734-677-7400