Organization
NORTH WOODWARD CAPSULE IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANA MARIA MATHIS (OFFICE MANAGER)
(248) 351-0552
Entity
Organization
Contact information
Practice address
26771 W 12 MILE RD, STE 106, SOUTHFIELD, MI 48034-1539
(248) 351-0552
(248) 746-9588
Mailing address
26771 W 12 MILE RD, STE 106, SOUTHFIELD, MI 48034-1539
(248) 351-0552
(248) 746-9588
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301038180
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2733386
—
MI
Enumeration date
08/17/2006
Last updated
08/22/2020
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