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GREAT LAKES RADIOLOGY PLLC NPI 1154704948


NPI Information

NPI: 1154704948
Provider Name: GREAT LAKES RADIOLOGY PLLC
Classification: Radiologic Technologist - 2471C3402X
Entity Type: Organization

Specialization: Radiography

Address:
461 WEST HURON
PONTIAC, MI
ZIP 48341
Phone: (248) 857-7200
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GREAT LAKES RADIOLOGY PLLC is a radiography radiologic technologist in Pontiac, MI. The provider is a radiologic technologist who specializes in radiography (also known as x-rays) and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of radiographs, exam techniques, equipment protocols, radiation safety, and patient care. GREAT LAKES RADIOLOGY PLLC NPI is 1154704948. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

461 WEST HURON
PONTIAC, MI
ZIP 48341
Phone: (248) 857-7200

The provider's authorized official is Venicat Rudraraju .
The authorized official title is Owner and has the following contact phone number (248) 884-0003.

The enumeration date for this NPI number is 6/30/2015 and was last updated on 6/30/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12471C3402XRadiologic TechnologistRadiography4301067927MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.