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General NPI Number Information
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NPI Number | 1558409649
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Entity Type | Organization
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Legal Business Name | EASTPOINTE RADIOLOGISTS, PC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 21003 MACK AVE
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City | GROSSE POINTE WOODS
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State | MI
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Zip | 48236-1333
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Country | US
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Telephone | 313-881-0411
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Fax | 313-881-3099
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Provider Business Mailing Address
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Address Line | 21003 MACK AVE
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City | GROSSE POINTE WOODS
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State | MI
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Zip | 48236-1333
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Country | US
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Telephone | 586-741-3772
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Fax | 586-741-4604
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY HAMAME
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Credential | M.D.
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Telephone | 586-741-3772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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