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General NPI Number Information
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NPI Number | 1982997078
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Entity Type | Organization
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Legal Business Name | AFFILIATED DIAGNOSTIC OF OAKLAND LLC
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 26550 NORTHWESTERN HWY
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City | SOUTHFIELD
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State | MI
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Zip | 48076-3741
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Country | US
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Telephone | 248-809-3350
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Fax | 248-809-3531
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Provider Business Mailing Address
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Address Line | 26550 NORTHWESTERN HWY
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City | SOUTHFIELD
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State | MI
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Zip | 48076-3741
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Country | US
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Telephone | 248-809-3350
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Fax | 248-809-3531
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Authorized Official
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Title or Position | SUPERVISING PHYSICIAN
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Name | DR. WARREN J RINGOLD
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Credential | MD
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Telephone | 313-562-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 4301036838
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | 4301036838
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License Number State | MI
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