Organization
EAST BELTLINE IMAGING PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN TARATUTA PAC (OFFICE MANAGER)
(616) 456-9553
Entity
Organization
Contact information
Practice address
3210 EAGLE RUN DR NE, GRAND RAPIDS, MI 49525-7051
(616) 301-7500
(616) 301-3606
Mailing address
3210 EAGLE RUN DR NE, GRAND RAPIDS, MI 49525-7051
(616) 301-7500
(616) 301-3606
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
HS062163
MI
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32885
PRIORITY HEALTH
MI
01
—
700D115760
BLUE SHIELD
MI
Enumeration date
10/05/2006
Last updated
05/14/2024
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