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Organization
PAVILION IMAGING, LLC
Active
Organization
PAVILION IMAGING, LLC
Active
Parent organization
PHOENIX MEDICAL GROUP, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX MEDICAL GROUP, PC
Authorized official
MRS. ABBIE HILL (ADMINISTRATOR)
(248) 304-7647
Entity
Organization
Contact information
Practice address
29201 TELEGRAPH RD STE L-01, SOUTHFIELD, MI 48034-1301
(248) 304-7775
(248) 918-2033
Mailing address
29201 TELEGRAPH RD, SUITE 450, SOUTHFIELD, MI 48075-1331
(248) 304-7659
(248) 423-4683
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306075551
—
MI
Enumeration date
12/23/2014
Last updated
03/22/2018
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