Healthcare Provider Details

I. General information

NPI: 1114970027
Provider Name (Legal Business Name): INFINITY DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 12/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4248 BRECKENRIDGE DR
WEST BLOOMFIELD MI
48322-4431
US

IV. Provider business mailing address

4248 BRECKENRIDGE DR
WEST BLOOMFIELD MI
48322-4431
US

V. Phone/Fax

Practice location:
  • Phone: 248-626-1900
  • Fax: 248-786-5362
Mailing address:
  • Phone:
  • Fax: 248-786-5362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY SIGAL
Title or Position: VICE PRESIDENT
Credential:
Phone: 248-626-1900