Organization
MICHIGAN BIO TECH PARTNERS, LLC
Active
Other names
The Imaging Center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RAM GUNABALAN M.D. (PRESIDENT)
(248) 583-8922
Entity
Organization
Contact information
Practice address
15670 SOUTHFIELD RD, ALLEN PARK, MI 48101-2513
(313) 294-2897
(313) 294-2915
Mailing address
30781 STEPHENSON HWY, MADISON HEIGHTS, MI 48071-1618
(248) 583-8922
(248) 583-8969
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821095472
NPI
MI
01
—
310H222470
BCBS OF MICHIGAN
MI
01
—
DC3998
RAILROAD MEDICARE
MI
Enumeration date
06/28/2005
Last updated
04/29/2008
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