# ULTRA DIAGNOSTIC SERVICES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487955845
- **Authorized official:** DR. HENRY A SHEVITZ MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (313) 258-4855

## Contact information

- **Practice address:** 29600 NORTHWESTERN HWY, SUITE 106, SOUTHFIELD, MI 48034-1016
- **Practice address phone:** (313) 258-4855
- **Practice address fax:** (248) 671-5185
- **Mailing address:** 29600 NORTHWESTERN HIGHWAY, SUITE 106, SOUTHFIELD, MI 48034-1376
- **Mailing address phone:** (313) 258-4855
- **Mailing address fax:** (248) 671-5185

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207U00000X | Nuclear Medicine Physician | 4301028752 | MI | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2010
- **Last updated:** 12/20/2011