Organization
GREAT LAKES RADIOLOGY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MADISON (ORGANIZER)
(734) 673-3764
Entity
Organization
Contact information
Practice address
729 W ANN ARBOR TRL STE 2, PLYMOUTH, MI 48170-6225
(734) 673-3764
Mailing address
729 W ANN ARBOR TRL STE 2, PLYMOUTH, MI 48170-6225
(734) 673-3764
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
09/05/2025
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