Organization
INGHAM RADIOLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK CIMMERER MD (PRESIDENT)
(517) 372-9256
Entity
Organization
Contact information
Practice address
2909 E GRAND RIVER AVE, SUITE 102, LANSING, MI 48912-4300
(517) 372-9256
Mailing address
780 W LAKE LANSING RD, SUITE 800, EAST LANSING, MI 48823-8474
(517) 372-9256
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00465
PRIORITY HEALTH
MI
01
—
0C37602
BLUE CROSS BLUE SHIELD
MI
01
—
0C37603
BLUE CROSS BLUE SHIELD
MI
01
—
1002896
MCLAREN HEALTH ADVANTAGE
MI
01
—
1002897
MCLAREN HEALTH ADVANTAGE
MI
01
—
1017356
MCLAREN HEALTH ADVANTAGE
MI
01
—
105014
PREFERRED CHOICES
MI
01
—
9000251
HEALTHPLUS MI
MI
01
—
CE9698
RAILROAD MEDICARE
MI
01
—
CK0098
RAILROAD MEDICARE
MI
Enumeration date
08/04/2006
Last updated
08/22/2020
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