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Organization

MCGH COMPREHENSIVE BREAST SCREENING CENTER LLC

Active
Other names
MCRMC Comprehensive Breast Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN LISTON (VICE PRESIDENT OF TREASURY)
(586) 741-4156
Entity
Organization

Contact information

Practice address
43900 GARFIELD RD, SUITE 202, CLINTON TOWNSHIP, MI 48038-1128
(586) 412-5150
(586) 412-5165
Mailing address
43900 GARFIELD RD, SUITE 202, CLINTON TOWNSHIP, MI 48038-1128
(586) 412-5150
(586) 412-5165

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4458682
MI
05
4458691
MI
05
4458726
MI
Enumeration date
11/08/2006
Last updated
06/19/2008
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