Organization
WOODLAND IMAGING CENTER LLC
Active
Other names
Avant Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID JOSEPH FUGENSCHUH MD (MEDICAL DIRECTOR)
(734) 712-8350
Entity
Organization
Contact information
Practice address
7575 GRAND RIVER AVE, STE 103, BRIGHTON, MI 48114-9309
(734) 712-8350
Mailing address
7575 GRAND RIVER AVE, STE 103, BRIGHTON, MI 48114-9309
(734) 712-8350
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00350162
RAILROAD MEDICARE
MI
Enumeration date
05/13/2006
Last updated
10/16/2007
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