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General NPI Number Information
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NPI Number | 1801895412
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Entity Type | Organization
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Legal Business Name | NORTHERN IMAGING ASSOCIATES P C
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 416 CONNABLE AVE
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City | PETOSKEY
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State | MI
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Zip | 49770-2212
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Country | US
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Telephone | 810-625-4222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5617
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City | SAGINAW
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State | MI
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Zip | 48603-0617
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Country | US
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Telephone | 810-625-4222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL ANGILERI
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Credential | MD
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Telephone | 810-625-4222
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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 | MI
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