MEDICARE: MDO IMAGING ASSOCIATES PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CE1787	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	310B510660	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1386684892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MDO IMAGING ASSOCIATES PLC

Provider Business Mailing Address
First Line	:	2222 S LINDEN RD
Second Line	:	SUITE R
City	:	FLINT
State	:	MI
Zip	:	48532-5475
Country	:	US
Telephone Number	:	810-733-0450
Fax Number	:	810-733-3445

Provider Business Practice Location Address
First Line	:	2222 S LINDEN RD
Second Line	:	SUITE R
City	:	FLINT
State	:	MI
Zip	:	48532-5476
Country	:	US
Telephone Number	:	810-733-0450
Fax Number	:	810-733-3445

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JOHN S MORRISON
Credential	:	DO
Telephone Number	:	810-733-0450

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	11/06/2007

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Directions to “MDO IMAGING ASSOCIATES PLC ” Practice Location

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