Organization
NORTHERN RADIOLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL HARLAN D.O. (OWNER)
(800) 764-7297
Entity
Organization
Contact information
Practice address
14700 LAKE SHORE DRIVE, CHARLEVOIX, MI 49720
(231) 547-4024
Mailing address
1096 LACVUE, BOYNE CITY, MI 49712
(734) 677-7400
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
CH008593
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A510270
BCBS GROUP PIN
MI
01
—
300086775
RR MEDICARE
MI
01
—
3151500034
BLUE CROSS
MI
05
—
3450062
—
MI
Enumeration date
05/03/2007
Last updated
05/19/2008
Update your record
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