CENTRUM DIAGNOSTICS LLC (NPI# 1700066990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700066990 |
| Entity Type | Organization |
| Organization Name | CENTRUM DIAGNOSTICS LLC |
| Practice Address |
24901 Northwestern Hwy Suite 205 Southfield MI 48075-2203 |
| Mailing Address |
Po Box 382 Troy MI 48099-0382 |
| Practice Telephone | 2487460882 |
| Practice Fax Number | 2483572380 |
| Mailing Telephone | 2487460882 |
| Mailing Fax Number | 2483572380 |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-06 |
| Authorized Official Name | MR. CLARENCE O DIXON (PRESIDENT) |
| Authorized Official Telephone | 2486635311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
24901 NORTHWESTERN HWY SUITE 205 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023063443 | Consulting Physicians PC | Physical Medicine & Rehabilitation | 24901 Northwestern Hwy, Suite 205, Southfield, MI 48075-2203 | 2006-05-24 |
| 1114559895 | Dilpreet Khaira | Occupational Therapist | 24901 Northwestern Hwy, Southfield, MI 48075-2203 | 2020-02-10 |
| 1407381403 | Us Physical Rehabilitation Lc | Clinic/Center | 24901 Northwestern Hwy, Suite 113, Southfield, MI 48075-2203 | 2017-04-27 |
| 1063953834 | Daughter Status Foundation | Community/Behavioral Health | 24901 Northwestern Hwy, Suite 600, Southfield, MI 48075-2203 | 2017-03-13 |
| 1164968673 | Triune Care Inc | In Home Supportive Care | 24901 Northwestern Hwy, Ste 309, Southfield, MI 48075-2203 | 2017-01-09 |
| 1588119689 | Setu Sharma | Physical Therapist | 24901 Northwestern Hwy, Suite 113, Southfield, MI 48075-2203 | 2016-08-18 |
| 1952680878 | Med Source Services | Physical Medicine & Rehabilitation | 24901 Northwestern Hwy, Suite 205, Southfield, MI 48075-2203 | 2011-08-09 |
| 1154643112 | Med Source Services Inc | Independent Medical Examiner | 24901 Northwestern Hwy, Suite 205, Southfield, MI 48075-2203 | 2010-02-18 |
| 1730324898 | Megan Beth Gordon | Physical Therapist | 24901 Northwestern Hwy, Suite 205, Southfield, MI 48075-2203 | 2008-12-03 |
| 1689820268 | Jefferson Wiggins | Physical Therapist | 24901 Northwestern Hwy, Suite #113, Southfield, MI 48075 | 2008-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487832895 | Rachelle Bigras | Radiologic Technologist | 27207 Lahser, Ste 200b, Southfield, MI 48034-8471 | 2008-02-07 |
| 1992983951 | Rochelle Shipway | Radiologic Technologist | 27207 Lahser, Ste 200b, Southfield, MI 48034-8471 | 2008-02-01 |
| 1700064763 | Terresa Jeanette Pauline Hecox | Radiologic Technologist | 27207 Lahser, Ste 200b, Southfield, MI 48034-8471 | 2008-02-01 |
| 1730366840 | Dale Michael Miller | Radiologic Technologist | 27207 Lahser Rd, Ste 200b, Southfield, MI 48034-2168 | 2008-01-31 |
| 1376720490 | Kristin Noel Baxman | Radiologic Technologist | 27207 Lahser Rd, Ste 200b, Southfield, MI 48034-2168 | 2008-01-31 |
| 1487841367 | Medical Management Support Services Inc | Radiologic Technologist | 29829 Telegraph Rd, Suite 202, Southfield, MI 48034-1330 | 2007-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831440593 | Donald Gene Graham | Radiologic Technologist | 2751 Woodlake Rd Sw Apt 2, Wyoming, MI 49519-4653 | 2012-09-20 |
| 1275864464 | Robin Edward Feringa | Radiologic Technologist | 76181 33rd St, Lawton, MI 49065-9343 | 2010-01-27 |
| 1659592350 | Christine Mcneil | Radiologic Technologist | 7852 Rockcress Dr, Freeland, MI 48623-8431 | 2007-05-01 |
| 1063802270 | Veliisha Brown | Radiologic Technologist | 38777 6 Mile Rd, Suite 209, Livonia, MI 48152-2694 | 2015-01-26 |
| 1295125409 | Brad Kalleberg | Radiologic Technologist | 38777 6 Mile Rd, Livonia, MI 48152-2694 | 2015-01-26 |
| 1457740631 | Brittney Roach | Radiologic Technologist | 38777 6 Mile Rd, #209, Livonia, MI 48152-2694 | 2015-01-12 |
| 1356741946 | Skin Cancer Treatment Center of Michigan | Radiologic Technologist | 2246 N Monroe St, Ste 3, Monroe, MI 48162-4254 | 2014-09-02 |
| 1487091997 | Jason Wayne Jones | Radiologic Technologist | 205 N East Ave, Jackson, MI 49201-1753 | 2013-05-24 |
| 1841522141 | Michigan Visiting Physicians | Radiologic Technologist | 6240 Rashelle Dr, Suite 103, Flint, MI 48507-3934 | 2010-02-11 |
| 1154506335 | William Odell Hughes Jr. | Radiologic Technologist | 504 Main St, Suite J, Belleville, MI 48111-5600 | 2008-01-07 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.