PORTABLE DIAGNOSTIC ULTRASOUND IMAGING, INC. (NPI# 1861445439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861445439 |
| Entity Type | Organization |
| Organization Name | PORTABLE DIAGNOSTIC ULTRASOUND IMAGING, INC. |
| Practice Address |
21751 W 11 Mile Rd Suite 110 Southfield MI 48076-3712 |
| Mailing Address |
5584 Pembury West Bloomfield MI 48322-4011 |
| Practice Telephone | 2488726262 |
| Practice Fax Number | 2486715363 |
| Mailing Telephone | 2488726262 |
| Mailing Fax Number | 2486715363 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | ELEONORA RABKIN (PRESIDENT) |
| Authorized Official Telephone | 2488726262 |
| Authorized Official Credential | RCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246XS1301X |
Spec/Tech, Cardiovascular Specialization: Sonography |
0000010812 | MI | Technologists, Technicians & Other Technical Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5584 Pembury, West Bloomfield, MI 483224011 | 2488726262 | 2486715363 |
| Street Address |
21751 W 11 MILE RD SUITE 110 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48076-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083672166 | Jenifer Yorke Segal | Physical Therapist | 21751 W 11 Mile Rd, Suite 110, Southfield, MI 48076-3712 | 2006-05-01 |
| 1023578499 | Shalynne Lynnatt Barr | Nutritionist | 21751 W 11 Mile Rd, Suite 208, Southfield, MI 48076-3780 | 2019-03-22 |
| 1972023356 | Hindy Levine | Counselor | 21751 W 11 Mile Rd, Southfield, MI 48076-3712 | 2017-06-26 |
| 1104255058 | Marie D Libbey | Nurse Practitioner | 21751 W 11 Mile Rd, Suite #105, Southfield, MI 48076-3712 | 2013-11-01 |
| 1528261781 | Omid Entezami | Physical Therapist | 21751 W 11 Mile Rd, Suite 109, Southfield, MI 48076-3712 | 2007-06-06 |
| 1215033311 | Advanced Spine and Headache Center | Family Medicine | 21751 W 11 Mile Rd, Suite 110, Southfield, MI 48076-3712 | 2006-09-15 |
| 1073526174 | Alex Meltser | Chiropractor | 21751 W 11 Mile Rd, Suite 110, Southfield, MI 48076-3712 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1295353829 | Marian Hannah Ibrahim | Dentist | 19189 W 12 Mile Rd, Lathrup Village, MI 48076 | 2020-07-09 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760035752 | Taliah Laneice Williams-hunter | Counselor | 30119 Sparkleberry Dr., Southfield, MI 48076 | 2019-07-19 |
| 1386114742 | Mavis Gail Pookrum | Technician | 21732 Colony Park Circle #105, Southfield, MI 48076 | 2018-11-28 |
| 1861962417 | Millennial Infusion Centers Inc | Clinic/Center | 26250 Northwestern Hwy Ste 201, Southfield, MI 48076 | 2018-11-27 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1437675758 | Kenneth Gerard Giles | Counselor | 29532 Southfield Rd. Suite 208, Southfield, MI 48076 | 2017-08-17 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| Find all providers in zip 48076 | ||||
| Taxonomy Code | 246XS1301X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Cardiovascular |
| Specialization | Sonography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033739032 | Teather M Sebastian | Spec/Tech, Cardiovascular | 11134 Face Hwy, Nashville, MI 49073-9120 | 2020-04-20 |
| 1578128963 | Premier Mobile Imaging, LLC | Spec/Tech, Cardiovascular | 6323 Quailey Dr Se, Grand Rapids, MI 49546-7113 | 2019-05-01 |
| 1215463500 | Judd Dotson | Spec/Tech, Cardiovascular | 87 N Avery Rd, Waterford, MI 48328-2903 | 2017-05-04 |
| 1780139543 | Cardiovascular Ultrasound Solutions, LLC | Spec/Tech, Cardiovascular | 77 South 20th Street, Cardio Suite, Battle Creek, MI 49015 | 2016-08-22 |
| 1649556408 | Daljit Bath | Spec/Tech, Cardiovascular | 11475 Maple Valley Dr, Plymouth, MI 48170-6391 | 2011-10-25 |
| 1447332325 | Quality Imaging LLC | Spec/Tech, Cardiovascular | 31442 Hartford Dr, Warren, MI 48088-7307 | 2006-10-19 |
| 1942289038 | 2d Cardiac Imaging, Inc. | Spec/Tech, Cardiovascular | 3170 Christy Way, Suite 2, Saginaw, MI 48603-2256 | 2006-01-17 |
| 1588150064 | Echocardiography On Wheels, Lc | Spec/Tech, Cardiovascular | 120 Water St, Boyne City, MI 49712 | 2018-07-07 |
| 1811483571 | Tiffany Marie Faulknor | Spec/Tech, Cardiovascular | 120 Water St, Boyne City, MI 49712 | 2018-07-05 |
| 1811311418 | Crv Imaging Consultants, Inc. | Spec/Tech, Cardiovascular | 26711 Woodward Ave, Suite Ll-b, Huntington Woods, MI 48070-1333 | 2014-02-18 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48076 |
Please comment or provide details below to improve the information on PORTABLE DIAGNOSTIC ULTRASOUND IMAGING, INC..
| 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.