Organization
TRIAD DIAGNOSTIC TECHNOLOGIES, LLC.
Active
Other names
TRIAD DIAGNOSTICS
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN J MAYRAND (PRESIDENT/CEO)
(248) 421-5420
Entity
Organization
Contact information
Practice address
30514 KNIGHTON DR, FARMINGTON HILLS, MI 48331-5929
(877) 572-3837
(248) 319-0354
Mailing address
869 LAKE SHORE RD, GROSSE POINTE SHORES, MI 48236-1274
(248) 421-5420
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310F303370
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/05/2006
Last updated
01/08/2024
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