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General NPI Number Information
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NPI Number | 1588908222
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Entity Type | Organization
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Legal Business Name | MID MICHIGAN ADVANCED IMAGING LLC
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 4905 BERL DR
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City | SAGINAW
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State | MI
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Zip | 48604-2801
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Country | US
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Telephone | 810-768-3779
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Fax | 810-606-0656
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Provider Business Mailing Address
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Address Line | 8273 S SAGINAW ST STE D
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City | GRAND BLANC
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State | MI
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Zip | 48439-2465
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Country | US
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Telephone | 810-606-0656
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Fax | 810-606-0662
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Authorized Official
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Title or Position | PARTNER
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Name | MR. ZAKWAN ABOUDANE
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Credential |
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Telephone | 810-606-0656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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