MID MICHIGAN DIAGNOSTIC CORP (NPI# 1760638241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760638241 |
| Entity Type | Organization |
| Organization Name | MID MICHIGAN DIAGNOSTIC CORP |
| Other Organization Name | MID MICHIGAN DIAGNOSTICS |
| Practice Address |
3400 Fleckenstein Rd Suite D Flint MI 48507-3043 |
| 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 |
|---|---|---|---|---|---|
| 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 |
| 1306092887 | Mid Michigan Diagnostic Corp | Internal Medicine | 2137 W M 61, Gladwin, MI 48624-8463 | 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 |
3400 FLECKENSTEIN RD SUITE D |
| City | FLINT |
| State | MI |
| Zip Code | 48507-3043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083688725 | Kazem Hak | Internal Medicine | 3400 Fleckenstein Rd, Suite 3, Flint, MI 48507-3043 | 2006-02-16 |
| 1730731829 | Jessica Renee Samuelson | Nurse Practitioner | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2019-07-10 |
| 1538606546 | Dayna Rae-edgerton Timmreck | Nurse Practitioner | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2017-01-28 |
| 1811386527 | Evolution Imaging | Radiology | 3400 Fleckenstein Rd, Suite C, Flint, MI 48507-3042 | 2015-01-19 |
| 1114328861 | Medquest Imaging L.l.c | Physiological Laboratory | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2014-09-12 |
| 1801209549 | Comprehensive Pain Specialists, Pllc | Pain Medicine | 3400 Fleckenstein Rd, Suite 1, Flint, MI 48507-3042 | 2014-06-10 |
| 1255696092 | Douglas Joseph Boven II | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2012-07-09 |
| 1659664092 | Bps-sar Pllc | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Suite 4, Flint, MI 48507-3042 | 2011-05-18 |
| 1265687321 | Millenium North PC | Internal Medicine | 3400 Fleckenstein Rd, Suite 3, Flint, MI 48507-3043 | 2008-11-17 |
| 1124225255 | Carlo E Adams | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Suite 1, Flint, MI 48507-3042 | 2007-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847870 | Alexis Nichole Leach | Physician Assistant | 5494 South Dort Hwy, Flint, MI 48507 | 2020-09-28 |
| 1508330317 | Jeffrey Mark Funck | Registered Nurse | G-4443 Miller Road, Suite 100, Flint, MI 48507 | 2019-01-15 |
| 1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
| 1760984348 | Melissa Dawn Hoffman | Psychologist | 5402 Gateway Centre Drive, Suite B, Flint, MI 48507 | 2018-02-28 |
| 1902327323 | Katee Mast | Case Manager/Care Coordinator | 110 Eldon Baker Drive, Flint, MI 48507 | 2017-07-06 |
| 1699228460 | Joshua Sinclair | Social Worker | 2442 E Maple Ave Ste 207, Flint, MI 48507 | 2016-07-28 |
| 1477903730 | Gracie Hunter | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1110 Eldon Baker, Flint, MI 48507 | 2016-06-17 |
| 1528412822 | Drita Gojcaj | Massage Therapist | 3426 Miller Road, Flint, MI 48507 | 2016-04-22 |
| 1629422100 | Ellen Makarewicz-ely | Massage Therapist | 3426 Miller Rd, Flint, MI 48507 | 2016-04-20 |
| 1700262722 | Katelyn Bailey | Nurse Practitioner | 1420 W Twelfth St, Flint, MI 48507 | 2015-07-31 |
| Find all providers in zip 48507 | ||||
| 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 |
|---|---|---|---|---|
| 1083866008 | Lily Lim | Radiology | 1173 Dyemeadow Ln, Flint, MI 48532-2316 | 2008-10-22 |
| 1982856951 | D/b/a Bristol Road Imaging Center | Radiology | G 5067 W Bristol Rd, Suite K, Flint, MI 48507 | 2008-10-21 |
| 1619135712 | Barry J. Rosen, D.o.,pc | Radiology | 1517 Wildwood Ct, Flint, MI 48532-2079 | 2008-05-27 |
| 1477583227 | Vikram Rao | Radiology | 2370 S Linden Rd, Suite 300, Flint, MI 48532-5424 | 2006-07-04 |
| 1043254584 | Charles Avila King II | Radiology | 1241 Dyemeadow Ln, Flint, MI 48532-2319 | 2006-06-15 |
| 1144263831 | Apparao Mukkamala | Radiology | Hurley Medical Center, One Hurley Plaza, Radiology Dept, Flint, MI 48503 | 2006-06-13 |
| 1790750966 | Diagnostic Radiology Associates of Flint PC | Radiology | 501 S Ballenger Hwy, Suite B, Flint, MI 48532-3641 | 2006-02-21 |
| 1720053473 | Walter Davis Harper | Radiology | 3346 Lennon Road, Flint, MI 48507-1015 | 2006-02-17 |
| 1427057967 | Regional Medical Imaging, P.C. | Radiology | 3346 Lennon Rd, Flint, MI 48507-1015 | 2005-07-18 |
| 1811386527 | Evolution Imaging | Radiology | 3400 Fleckenstein Rd, Suite C, Flint, MI 48507-3042 | 2015-01-19 |
| Find all providers in FLINT | ||||
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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.