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General NPI Number Information
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NPI Number | 1639497274
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Entity Type | Organization
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Legal Business Name | SENTINEL HEALTH STAFFING LLC
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 06/21/2019
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Provider Practice Location Address
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Address Line | 29155 NORTHWESTERN HWY STE 642
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1011
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Country | US
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Telephone | 313-657-4282
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Fax | 248-250-5859
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Provider Business Mailing Address
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Address Line | 29155 NORTHWESTERN HWY STE 642
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1011
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Country | US
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Telephone | 313-657-4282
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Fax | 248-250-5859
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Authorized Official
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Title or Position | OWNER
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Name | ANTONIO L BALL
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Credential |
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Telephone | 313-657-4282
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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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Taxonomy #2
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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