SHELBY-MACOMB DIAGNOSTIC CENTER, PLC (NPI# 1891097853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891097853 |
| Entity Type | Organization |
| Organization Name | SHELBY-MACOMB DIAGNOSTIC CENTER, PLC |
| Practice Address |
50505 Schoenherr Rd Suite 010 Shelby Township MI 48315-3140 |
| Mailing Address |
50505 Schoenherr Rd Suite 300 Shelby Township MI 48315-3140 |
| Practice Telephone | 5867315849 |
| Practice Fax Number | 5867315862 |
| Mailing Telephone | 5867265566 |
| Mailing Fax Number | 5867268085 |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2010-11-24 |
| Authorized Official Name | DR. ANTONIO MORREALE III (PRESIDENT OF SHELBY MACOMB DIAG CTR) |
| Authorized Official Telephone | 5867265566 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | ASSOCIATED INTERNISTS OF MACOMB, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
50505 SCHOENHERR RD SUITE 010 |
| City | SHELBY TOWNSHIP |
| State | MI |
| Zip Code | 48315-3140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051127 | Grant Adam Lange | Internal Medicine | 50505 Schoenherr Rd, Suite 300, Shelby Township, MI 48315-3140 | 2005-05-27 |
| 1366092769 | Carly Knudsen | Nurse Practitioner | 50505 Schoenherr Rd, Ste 340, Shelby Township, MI 48315-3140 | 2019-09-17 |
| 1497281935 | Nicole Erin Graessle | Nurse Practitioner | 50505 Schoenherr Rd, Shelby Township, MI 48315 | 2017-05-03 |
| 1013455922 | Russell Miller | Nurse Practitioner | 50505 Schoenherr Rd, Ste. 340, Shelby Township, MI 48315-3140 | 2017-02-11 |
| 1699223982 | Elizabeth Anne White | Dermatology | 50505 Schoenherr Rd, Suite 325, Shelby Township, MI 48315-3140 | 2016-09-14 |
| 1558761510 | Rachel Menger | Counselor | 50505 Schoenherr Rd, Shelby Township, MI 48315-3140 | 2014-08-27 |
| 1003222902 | Ciara Braun | Counselor | 50505 Schoenherr Rd, Suite 270, Shelby Township, MI 48315-3140 | 2014-07-11 |
| 1417361361 | Cynthia Shields | Nurse Practitioner | 50505 Schoenherr Rd, Suite 340, Shelby Township, MI 48315-3140 | 2014-06-19 |
| 1003226622 | Gi Medical Assoc PC | Internal Medicine | 50505 Schoenherr Rd, 250, Shelby Township, MI 48315-3140 | 2014-05-05 |
| 1639594799 | Stephanie Bazydlo | Dietitian, Registered | 50505 Schoenherr Rd, Suite 240, Shelby Township, MI 48315-3140 | 2014-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885500 | Steven William Scavone | Counselor | 45660 Schonherr Rd., Shelby Township, MI 48315 | 2020-09-08 |
| 1861039844 | Lauren Nicole Himmel | Physician Assistant | 13051 Michael Dr., Shelby Twp., MI 48315 | 2019-12-09 |
| 1881173763 | Shelby Family Cosmetic & Restorative Dentistry | Dentist | 51221 Schoenherr Road., Suite 102, Shelby Township, MI 48315 | 2018-08-10 |
| 1023594223 | Apex Chiropractic, P.C. | Chiropractor | 51543 Schoenherr Road, Shelby Township, MI 48315 | 2018-07-11 |
| 1053809145 | Bam Management | Clinic/Center | 13433 Hall Road, Utica, MI 48315 | 2018-04-25 |
| 1659723203 | Patricia Gates | Registered Nurse | 23066 Balcombe, Utica, MI 48315 | 2016-07-07 |
| 1124481213 | Jai Shree Umiya Inc | Durable Medical Equipment & Medical Supplies | 13350 24 Mile Rd Ste 300, Shelby Township, MI 48315 | 2016-04-05 |
| 1679931828 | Team Rehabilitation S3, LLC | Physical Therapist | 13350 24 Mile Road, Suite 500, Shelby Township, MI 48315 | 2016-02-03 |
| 1164816484 | Sylvia White | Case Manager/Care Coordinator | 47100 Schoenherr Rd. Suite D, Shelby Township, MI 48315 | 2015-03-25 |
| 1770921389 | Amy Christine Vitale | Speech-Language Pathologist | 14145 Simone Dr., Developing Connections Inc, Shelby Twp, MI 48315 | 2013-06-06 |
| Find all providers in zip 48315 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | SHELBY TOWNSHIP |
| Zip Code | 48315 |
Please comment or provide details below to improve the information on SHELBY-MACOMB DIAGNOSTIC CENTER, PLC.
| 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.