HENRY FORD MACOMB ANCILLARY SERVICES (NPI# 1689062911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689062911 |
| Entity Type | Organization |
| Organization Name | HENRY FORD MACOMB ANCILLARY SERVICES |
| Other Organization Name | HENRY FORD MACOMB IMAGING CENTER-MT. CLEMENS |
| Practice Address |
133 S Main St Mount Clemens MI 48043-2308 |
| Mailing Address |
15855 19 Mile Rd Attn: Terry Goodbalian Clinton Township MI 48038-3504 |
| Practice Telephone | 5864681600 |
| Practice Fax Number | 5864650329 |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-03-03 |
| Authorized Official Name | TERRY GOODBALIAN (VP FINANCE & CFO HFMACOMB) |
| Authorized Official Telephone | 5862632705 |
| Is Organization Subpart | Y |
| Parent Organization Name | HENRY FORD MACOMB HOSPITAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 293D00000X | Physiological Laboratory | Laboratories | ||
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| HENRY FORD MACOMB IMAGING CENTER-MT. CLEMENS | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669864708 | Henry Ford Macomb Ancillary Services | Clinical Medical Laboratory | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-02-26 |
| Street Address |
133 S MAIN ST |
| City | MOUNT CLEMENS |
| State | MI |
| Zip Code | 48043-2308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306842190 | Internal Medicine Associates of Mt. Clemens, PC | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2005-06-26 |
| 1669973194 | Kathryn Loren | Social Worker | 133 S Main St, Mount Clemens, MI 48043-2308 | 2018-02-21 |
| 1225406259 | Joseph Scherba | Physician Assistant | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-09-08 |
| 1396111860 | Nicole Cherie Williams | Nurse Practitioner | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-08-19 |
| 1073999629 | Nicole Marie Shields | Physician Assistant | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-08-05 |
| 1669864708 | Henry Ford Macomb Ancillary Services | Clinical Medical Laboratory | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-02-26 |
| 1578973962 | Lubna Sarraf | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2014-05-06 |
| 1841615648 | Alliance Health Professionals, Pllc | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2014-03-03 |
| 1962763078 | Jahir Eduardo Ramos | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2012-06-05 |
| 1497074264 | Nikhil Vivek Ambulgekar | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043 | 2010-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1265086136 | Venture Counseling | Social Worker | 198 S. Main Street, Suite 2, Mount Clemens, MI 48043 | 2019-07-30 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1730669706 | Wynn A Mitchell | Case Manager/Care Coordinator | 24 Hubbard St, Mount Clemens, MI 48043 | 2018-08-18 |
| 1629520101 | Boitshoko Marang | Family Medicine | Clinton River Drive 11a, Mount Clemens, MI 48043 | 2016-10-31 |
| 1720332265 | New Passages | Point of Service | 175 N. Grorsebeck Hwy, Mt. Clemens, MI 48043 | 2012-11-06 |
| 1376807784 | Christopher John Shamass | Emergency Medicine | 1000 Harrington Boulevard, Mount Clemens, MI 48043 | 2012-06-29 |
| 1265749683 | Mycare Health Center | Clinic/Center | 18 Market Street, Suite C, Mount Clemens, MI 48043 | 2010-09-07 |
| 1114102837 | George Edward Perron | Family Medicine | 256 Wellington Crescent, Mt Clemens, MI 48043 | 2007-12-31 |
| 1558568733 | Dawood Ghassan Dalaly | Surgery | 1000 Harrington, Mt Clemens, MI 48043 | 2007-06-29 |
| Find all providers in zip 48043 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265030068 | Copper Ridge Health PC | Clinic/Center | 4290 Copper Ridge Dr Ste 100, Traverse City, MI 49684-7256 | 2020-10-14 |
| 1043705163 | Elite Medical Diagnostics LLC | Clinic/Center | 30700 Telegraph Rd Ste 1536, Bingham Farms, MI 48025-4590 | 2018-07-01 |
| 1275022980 | Bellin Health Iron Mountain Inc | Clinic/Center | 440 Woodward Ave Ste A, Iron Mountain, MI 49801-4631 | 2018-05-08 |
| 1114416906 | Bellin Health Iron Mountain Inc | Clinic/Center | 2845 Highway Us2 and 41, Suite 202, Bark River, MI 49807 | 2018-05-07 |
| 1972092831 | Bellin Health Iron Mountain Inc | Clinic/Center | 2001 Minneapolis Ave Ste D, Gladstone, MI 49837-2060 | 2018-05-07 |
| 1437676871 | Diagnostic Solutions Pllc | Clinic/Center | 29877 Telegraph Rd Ste 400b, Southfield, MI 48034-7661 | 2017-08-25 |
| 1659769867 | Pavilion Imaging, LLC | Clinic/Center | 29201 Telegraph Rd Ste L-01, Southfield, MI 48034-1301 | 2014-12-23 |
| 1194143982 | Hurley Medical Center | Clinic/Center | 5494 S Dort Hwy, Flint, MI 48507-4483 | 2014-03-31 |
| 1003105420 | Envision Diagnostic Ultrasound Imaging LLC | Clinic/Center | 2715 Seneca St, Flint, MI 48504-5106 | 2011-04-06 |
| 1174848600 | Professional Diagnostic Imagiging Pllc | Clinic/Center | 4284 Echo Rd, Bloomfield Hills, MI 48302-1943 | 2010-03-27 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT CLEMENS |
| Zip Code | 48043 |
Please comment or provide details below to improve the information on HENRY FORD MACOMB ANCILLARY SERVICES.
| 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.