Organization
ADVANCED RADIOLOGY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RITA WESTPHAL (CAO)
(616) 363-7339
Entity
Organization
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 363-7290
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 363-7290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
502389
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N78710
MEDICARE PA GROUP
MI
01
—
0N99420
MEDICARE NP GROUP
MI
01
—
300D110870
BLUE CROSS BLUE SHIELD
MI
01
—
500D114350
BLUE CROSS BLUE SHIELD NP
MI
01
—
CN1919
RAILROAD MEDICARE
MI
01
—
CN1920
RAILROAD MEDICARE
MI
01
—
P63018
BLUE CARE NETWORK
MI
Enumeration date
05/27/2005
Last updated
06/12/2019
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