Organization
ST. JOHN MACOMB-OAKLAND HOSPITAL
Active
Other names
MRI Center Oakland
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER JOHNSON (DIRECTOR)
(877) 996-9975
Entity
Organization
Contact information
Practice address
27379 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 398-4488
(248) 398-4994
Mailing address
43750 GARFIELD RD, SUITE 211, CLINTON TOWNSHIP, MI 48038-1135
(586) 228-4652
(586) 228-4533
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
MI
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
MI
261QR0200X
Radiology Clinic/Center
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300F301350
BCBS GROUP NUMBER
MI
01
—
DA0334
RAILROAD MEDICARE GROUP NUMBER
MI
Enumeration date
06/25/2006
Last updated
01/27/2011
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