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Organization

SUPERIOR IMAGING SPECIALISTS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER MEHALL M.D. (PRESIDENT)
(906) 225-7808
Entity
Organization

Contact information

Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-7808
(906) 225-7818
Mailing address
2837 US 41 WEST, MARQUETTE, MI 49855-2675
(906) 225-3964
(906) 226-3875

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301052676
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104352558
MI
05
104968532
MI
05
104968541
MI
01
310E210240
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
11/29/2005
Last updated
05/29/2009
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