Healthcare Provider Details
I. General information
NPI: 1346646494
Provider Name (Legal Business Name): MAPLEVIEW DIAGNOSTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2014
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35200 DEQUINDRE RD SUITE 400
STERLING HTS MI
48310-4837
US
IV. Provider business mailing address
35200 DEQUINDRE RD SUITE 400
STERLING HTS MI
48310-4837
US
V. Phone/Fax
- Phone: 586-826-8600
- Fax: 248-545-4737
- Phone: 586-826-8600
- Fax: 248-545-4737
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YS0012X |
| Taxonomy | Sleep Medicine (Otolaryngology) Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
R
LITTLE
Title or Position: OWNER
Credential: MD
Phone: 586-826-8600