Organization
MID MICHIGAN RADIOLOGY ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHANNES BUITEWEG M.D. (OWNER/PHYSICIAN)
(989) 773-2081
Entity
Organization
Contact information
Practice address
211 S CRAPO ST, SUITE F, MT PLEASANT, MI 48858
(989) 773-2081
(989) 773-3418
Mailing address
211 S CRAPO ST STE F, MT PLEASANT, MI 48858-2961
(989) 773-2081
(989) 773-3418
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1379244
—
MI
01
—
300C76006
BCBS OF MICHIGAN
MI
Enumeration date
09/21/2006
Last updated
02/19/2019
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