MID MICHIGAN DIAGNOSTIC CORP (NPI# 1306092887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306092887 |
| Entity Type | Organization |
| Organization Name | MID MICHIGAN DIAGNOSTIC CORP |
| Other Organization Name | MID MICHIGAN DIAGNOSTICS |
| Practice Address |
2137 W M 61 Gladwin MI 48624-8463 |
| Mailing Address |
1513 S Center Rd Burton MI 48509-1728 |
| Practice Telephone | 8107428770 |
| Practice Fax Number | 8107428772 |
| Mailing Telephone | 8107428770 |
| Mailing Fax Number | 8107428772 |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2009-04-22 |
| Authorized Official Name | MR. ZAKWAN ABOUDANE (OWNER) |
| Authorized Official Telephone | 8107428770 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mid MIchigan Diagnostics | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508800822 | Mid Michigan Diagnostic Corp | Internal Medicine | 1309 S Linden Rd Ste A, Flint, MI 48532-3443 | 2006-06-16 |
| 1093962342 | Mid Michigan Diagnostic Corp | Radiology | 1513 S Center Rd, Burton, MI 48509-1728 | 2008-08-19 |
| 1134375611 | Mid Michigan Diagnostic Corp | Internal Medicine | 3323 Shattuck Rd, Saginaw, MI 48603-3184 | 2008-08-15 |
| 1760638241 | Mid Michigan Diagnostic Corp | Radiology | 3400 Fleckenstein Rd, Suite D, Flint, MI 48507-3043 | 2008-08-15 |
| 1285800417 | Mid Michigan Diagnostic Corp | Internal Medicine | 1309 S Linden Rd Ste A, Flint, MI 48532-3443 | 2008-05-07 |
| Street Address |
2137 W M 61 |
| City | GLADWIN |
| State | MI |
| Zip Code | 48624-8463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629023924 | Hicham Churbaji | Internal Medicine | 2137 W M 61, Gladwin, MI 48624-8463 | 2006-05-24 |
| 1922330851 | Gladwin Family Care Center | Specialist | 2137 W M 61, Gladwin, MI 48624-8463 | 2010-02-03 |
| 1356524789 | Gladwin Family Practice | Licensed Practical Nurse | 2137 W M 61, Gladwin, MI 48624-8463 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558889162 | Jacob Cameron Shell | Specialist/Technologist | 4403 Betty Lee Blvd, Gladwin, MI 48624 | 2017-09-03 |
| 1750704268 | Monica Maebel Weaver | Licensed Practical Nurse | 1426 North St. Street, Affordable Nursing Inc, Gladwin, MI 48624 | 2014-02-04 |
| 1417397407 | Richard Allen White | Registered Nurse | 655 East Cedar Avenue, Gladwin, MI 48624 | 2013-07-05 |
| 1023453040 | Amy Rebecca Brockschmidt | Counselor | Ten16 Recovery Network, 1302 Chatterton St. 2, Gladwin, MI 48624 | 2013-05-03 |
| 1447558341 | Erika Dianis | Psychologist | 655 E. Cedar Ave., Gladwin, MI 48624 | 2011-03-02 |
| 1457519456 | Bont & Medical Products Inc | Durable Medical Equipment & Medical Supplies | 895 N M18 Suite 2, Gladwin, MI 48624 | 2008-05-27 |
| 1346424454 | Regional Dialysis Services Inc | Clinic/Center | 673 Quarter Street, Gladwin, MI 48624 | 2007-12-26 |
| 1548476070 | Sambamurti . Srinivasan | Family Medicine | 602 Riverview Ct, Gladwin, MI 48624 | 2007-05-14 |
| 1295957850 | Midmichigan Visiting Nurse Association | Durable Medical Equipment & Medical Supplies | 1234 W Cedar Ave, Gladwin, MI 48624 | 2007-05-03 |
| 1710063755 | Janet Flynn | Registered Nurse | 1207 N Spring St, Gladwin, MI 48624 | 2006-10-31 |
| Find all providers in zip 48624 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972653970 | Midland Radiology Associates PC | Radiology | 455 Quarter St, Gladwin, MI 48624-1918 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855667 | Joshua Boulter | Radiology | 2250 Providence Drive, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-11 |
| 1679197693 | Shyam Amin | Radiology | Academic Internal Medicine 2 2250 Providence Dr, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-05 |
| 1871116509 | Anthony Diebes | Radiology | 16001 W 9 Mile Rd Bldg 4th, Southfield, MI 48075-4818 | 2020-05-28 |
| 1548823800 | Alexander Paul Kaechele | Radiology | 16001 West 9 Mile Road, Suite #416, Southfield, MI 48075-4818 | 2019-04-22 |
| 1790246627 | Genesis Healthcare | Radiology | 8560 N Silvery Ln Ste 101, Dearborn Heights, MI 48127-4516 | 2019-03-25 |
| 1023572831 | Proscan Imaging Southfield Pllc | Radiology | 29877 Telegraph Rd # 11, Southfield, MI 48034-1332 | 2019-01-25 |
| 1295204253 | Easy Imaging, LLC | Radiology | 16100 19 Mile Rd Ste X, Clinton Township, MI 48038-1148 | 2018-11-20 |
| 1205304888 | Ascension Medical Group Genesys | Radiology | 1096 S Belsay Rd Ste J, Burton, MI 48509-1948 | 2018-11-13 |
| 1336626696 | Quantum Medical Radiology of California, P.C. | Radiology | 1625 Bear Creek Ln Unit O, Petoskey, MI 49770-8378 | 2018-07-19 |
| 1376072488 | Cambridge Institute of Minimally Invasive Therapies Pllc | Radiology | 2007 E 14 Mile Rd, Sterling Heights, MI 48310-5905 | 2017-06-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.