Organization
ST JOHN HOSPITAL AND MEDICAL CENTER
Active
Other names
Romeo Plank Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JOHNSON (DIRECTOR)
(877) 996-9975
Entity
Organization
Contact information
Practice address
46591 ROMEO PLANK RD, SUITE 137, MACOMB, MI 48044-5742
(586) 226-6226
(586) 226-6255
Mailing address
PO BOX 67000, DEPARTMENT 184101, DETROIT, MI 48267-0002
(877) 996-9975
(586) 228-4533
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
MI
2085N0700X
Neuroradiology Physician
—
MI
2085N0904X
Nuclear Radiology Physician
—
MI
2085P0229X
Pediatric Radiology Physician
—
MI
2085R0202X
Diagnostic Radiology Physician
Primary
—
MI
2085R0204X
Vascular & Interventional Radiology Physician
—
MI
2085U0001X
Diagnostic Ultrasound Physician
—
MI
247100000X
Radiologic Technologist
—
MI
2471B0102X
Bone Densitometry Radiologic Technologist
—
MI
2471C3402X
Radiography Radiologic Technologist
—
MI
2471M2300X
Mammography Radiologic Technologist
—
MI
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
—
MI
2471S1302X
Sonography Radiologic Technologist
—
MI
2471V0105X
Vascular Sonography Radiologic Technologist
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310E022080
BCBSM GROUP NUMBER
MI
Enumeration date
07/23/2008
Last updated
01/27/2011
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