Organization
MICHIGAN INSTITUTE FOR RADIATION ONCOLOGY/MIRO CANCER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARIDEH R. BAGNE PH.D., J.D. (CEO)
(248) 338-0300
Entity
Organization
Contact information
Practice address
70 FULTON ST, PONTIAC, MI 48341-2755
(248) 338-0300
(248) 338-0663
Mailing address
70 FULTON ST, PONTIAC, MI 48341-2755
(248) 338-0300
(248) 338-0663
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
02/22/2006
Last updated
08/22/2020
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