Organization
MICHIGAN VISITING PHYSICIANS
Active
Other names
Great Lakes Portable Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
RAM GUNABALAN M.D. (OWNER)
(586) 279-9850
Entity
Organization
Contact information
Practice address
6240 RASHELLE DR, SUITE 103, FLINT, MI 48507-3934
(586) 279-3250
Mailing address
6240 RASHELLE DR, SUITE 103, FLINT, MI 48507-3934
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
429780
MI
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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