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Organization

MICHIGAN MEDICAL DIAGNOSTIC CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHAHROKH MANSOORI M.D. (OWNER)
(248) 844-2980
Entity
Organization

Contact information

Practice address
135 BARCLAY CIR, SUITE 109, ROCHESTER HILLS, MI 48307-4599
(248) 844-2980
(248) 844-2983
Mailing address
135 BARCLAY CIR, SUITE 109, ROCHESTER HILLS, MI 48307-4599
(248) 844-2980
(248) 844-2983

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
AM076045
MI
207R00000X
Internal Medicine Physician
NM074148
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
SM038518
MI

Other

Enumeration date
06/05/2009
Last updated
01/09/2012
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