Organization
KENT RADIOLOGY PC
Active
Other names
West Michigan Business Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L PACIOREK MD (AUTHORIZED OFFICIAL)
(616) 685-5907
Entity
Organization
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503
(616) 364-6700
(616) 364-4960
Mailing address
PO BOX 5329, SAGINAW, MI 48603-0329
(616) 364-6700
(989) 401-4245
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300D148470
BCBS
MI
Enumeration date
07/11/2006
Last updated
09/10/2019
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