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ST JOHN HOSPITAL AND MEDICAL CENTER

Physicians Radiology Diagnostic Neuroimaging

Provider NPI: 1740445337

Organization Information:
Organization Name:  ST JOHN HOSPITAL AND MEDICAL CENTER
Organization is not Subpart
Authorized Official:  JENNIFER  JOHNSON  DIRECTOR  877-996-9975

Practice Location:
46591 ROMEO PLANK RD SUITE 137 MACOMB, MI 48044-5742 US
Tel: 586-226-6226  Fax: 586-226-6255

Business Mailing Address:
PO BOX 67000 DEPARTMENT 184101 DETROIT, MI 48267-0002 US
Tel: 877-996-9975  Fax: 586-228-4533

NPI Information:
NPI: 1740445337
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N2085D0003XPhysicians
Radiology
Diagnostic Neuroimaging
MI
N2085N0700XPhysicians
Radiology
MI
N2085N0904XPhysicians
Radiology
MI
N2085P0229XPhysicians
Radiology
MI
N2085R0204XPhysicians
Radiology
MI
N2085U0001XPhysicians
Radiology
MI
N247100000XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MI
N2471B0102XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MI
N2471C3402XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MI
N2471M2300XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MI
N2471N0900XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MI
N2471S1302XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MI
N2471V0105XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
MI
Y2085R0202XPhysicians
Radiology
MI

Other Provider Identifiers:

IssuerNumberStateType
BCBSM GROUP NUMBER310E022080MI01



American Medical Association 2012 taxonomy code information

Code: 2085R0202X

Type:

Classification:



Definition:



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