Organization
BOTSFORD MEDICAL IMAGING, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY MCKNIGHT DO (HEAD OF GROUP)
(248) 471-8371
Entity
Organization
Contact information
Practice address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(248) 471-8371
Mailing address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(248) 471-8371
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005741
HAP
MI
01
—
025821
MIDWEST HEALTH PLAN
MI
01
—
0F31877
BLUE CROSS BLUE SHIELD
MI
01
—
136309000
US DEPT OF LABOR WORKCOMP
MI
01
—
4468121
AETNA
MI
01
—
506640
CARE CHOICES
MI
01
—
600970
ULTIMED
MI
01
—
RA630003
M-CARE
MI
01
—
XX25381
HEALTHPLUS OF MI
MI
Enumeration date
05/23/2006
Last updated
02/24/2015
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