Organization
ISOMM LLC
Active
Other names
OPEN MRI MT PLEASANT
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNES BUITEWEG MD (PARTNER)
(989) 773-2081
Entity
Organization
Contact information
Practice address
211 S CRAPO ST, STE H, MT PLEASANT, MI 48858-2961
(734) 677-7400
(734) 677-7407
Mailing address
PO BOX 3701, ANN ARBOR, MI 48106-3701
(989) 773-2081
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C70065
BCBS GROUP
MI
Enumeration date
05/23/2011
Last updated
03/11/2014
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