Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SHORES DIAGNOSTIC LLC
Active
Organization
SHORES DIAGNOSTIC LLC
Active
Other names
The CT Center, Shores Diagnostic Pllc
Organization subpart
No
Provider details
NPI number
Authorized official
GULAM MOHIUDDIN (PRESIDENT)
(313) 285-8728
Entity
Organization
Contact information
Practice address
29230 RYAN RD STE C-1, WARREN, MI 48092-4274
(313) 285-8728
(313) 784-9055
Mailing address
29230 RYAN RD STE C-1, WARREN, MI 48092-4274
(313) 285-8728
(313) 784-9055
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104763580
—
MI
05
—
104763590
—
MI
05
—
114769270
—
MI
01
—
310E017130
BCBS OF MICHIGAN
MI
Enumeration date
11/08/2005
Last updated
03/25/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up