Organization
MACOMB MAGNETIC RESONANCE IMAGING CENTER INC
Active
Other names
Macomb MRI Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL ZUPAN (ADMINISTRATIVE DIRECTOR)
(586) 435-2031
Entity
Organization
Contact information
Practice address
8956 RELIABLE PARKWAY, CHICAGO, IL 60686-0001
(586) 566-1590
(586) 498-1559
Mailing address
42700 SCHOENHERR RD, STE 4, STERLING HEIGHTS, MI 48313-2874
(586) 566-1590
(586) 498-1559
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0202X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029324
CHAMPUS TRICARE
MI
01
—
1011238 0001
WELLNESS PLAN
MI
01
—
104904
PREFERRED CHOICES
MI
01
—
148900
GREAT LAKES HEALTH PLAN
MI
01
—
2377411
AETNA HMO
MI
01
—
300E06180
BLUE CROSS
MI
01
—
8332744
AETNA PPO
MI
01
—
84784A
HEALTH ALLIANCE PLAN
MI
01
—
P82732
BLUE CARE NETWORK
MI
01
—
RA820057
M CARE
MI
Enumeration date
06/09/2005
Last updated
03/21/2012
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