| NPI | 1518753441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARLOWE Credentialing Assistant 269-552-2823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging |
| 2085H0002X Radiology, Hospice and Palliative Medicine | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-06-04 |