Organization
MICHIGAN RADIATION ONCOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY ALAN MUDGE (M.D.)
(269) 245-8334
Entity
Organization
Contact information
Practice address
300 NORTH AVE, BATTLE CREEK, MI 49017-3307
(269) 245-8334
(269) 245-8335
Mailing address
PO BOX 1022, BATTLE CREEK, MI 49016-1022
(269) 245-8334
(269) 245-8335
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4301057699
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4434125
—
MI
01
—
P35860001
MI MEDICARE PTAN
MI
Enumeration date
04/27/2006
Last updated
10/02/2012
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