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General NPI Number Information
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NPI Number | 1891230900
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Entity Type | Organization
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Legal Business Name | MICHIGAN RADIOLOGY INSTITUTE PLLC
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Dates
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Enumeration Date | 12/28/2016
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 27501 WOODWARD AVE SUITE B
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City | BERKLEY
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State | MI
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Zip | 48072-0904
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Country | US
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Telephone | 248-268-2119
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Fax | 248-268-2164
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Provider Business Mailing Address
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Address Line | 27501 WOODWARD AVE SUITE B
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City | BERKLEY
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State | MI
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Zip | 48072-0904
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Country | US
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Telephone | 248-268-2119
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Fax | 248-268-2164
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHINTAN DESAI
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Credential | MD
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Telephone | 248-268-2119
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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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