Provider profile · NPI 1639438062
Advanced Diagnostic Medical Imaging Pc
Radiology, Diagnostic Radiology · Grosse Ile, MI · NPI 1639438062 · No federal exclusion match
✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.
Registry details
Type
Organization
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 4, 2012
License(s)
5101011021 (MI), 5101011021 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 19891 PARKE LN | Grosse Ile, MI 48138-1027 | 734-671-6677 |
| LOCATION | 19891 PARKE LN | Grosse Ile, MI 48138-1027 | 734-671-6677 |
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