Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Oct 20, 2006
License(s)
4301044266 (MI), 24606 (AZ), 4301044266 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3621 S STATE ST 700 KMS PLACE | Ann Arbor, MI 48108 | 734-936-2047 |
| LOCATION | 1500 E MEDICAL CENTER DR B2 FLOOR CANCER & GERIATRICS CENTER RM B2205 | Ann Arbor, MI 48109-5904 | 734-936-6274 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.