Organization
NUCLEAR CARDIAC IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE J SHARRARD (PRESIDENT)
(989) 326-0929
Entity
Organization
Contact information
Practice address
3491 S HURON RD, SUITE 2, BAY CITY, MI 48706-1547
(989) 667-6980
Mailing address
PO BOX 398, KAWKAWLIN, MI 48631-0398
(989) 667-6980
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
DS112843
MI
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4841927
—
MI
01
—
70 0Z910880
BCBS OF MICHIGAN
MI
Enumeration date
07/02/2006
Last updated
07/08/2013
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