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General NPI Number Information
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NPI Number | 1396046587
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 1320 WILKINS ST
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City | DETROIT
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State | MI
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Zip | 48207-4802
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Country | US
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Telephone | 313-656-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 WILKINS ST
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City | DETROIT
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State | MI
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Zip | 48207-4802
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Country | US
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Telephone | 313-656-2150
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ZEIA RUEDA CASAB SR.
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Credential | M.D,
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Telephone | 248-247-5869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301033492
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 4301024834
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | 4301024834
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 4301024834
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301024834
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 4301024834
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 4301024834
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301033492
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License Number State | MI
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