SOUTHFIELD RADIOLOGY ASSOCIATES PLLC (NPI# 1871525915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871525915 |
| Entity Type | Organization |
| Organization Name | SOUTHFIELD RADIOLOGY ASSOCIATES PLLC |
| Practice Address |
23100 Providence Dr Suite 420 Southfield MI 48075-3646 |
| Mailing Address |
16001 W 9 Mile Rd Southfield MI 48075-4818 |
| Practice Telephone | 2485694353 |
| Practice Fax Number | 2485695227 |
| Mailing Telephone | 2485694353 |
| Mailing Fax Number | 2485695227 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-11-21 |
| Authorized Official Name | DR. ROGER L GONDA JR. (PRESIDENT) |
| Authorized Official Telephone | 2485694353 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | A3477 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 0F36131 | 01 |
| Street Address |
23100 PROVIDENCE DR SUITE 420 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-3646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154759645 | Vibrus Group, LLC | Private Vehicle | 23100 Providence Dr, Suite 227, Southfield, MI 48075-3646 | 2013-10-22 |
| 1942551528 | Johanna E Mastry | Physical Therapist | 23100 Providence Dr, Suite 135, Southfield, MI 48075-3646 | 2012-09-24 |
| 1649587700 | Trustworthy Home Health Care, Inc. | Home Health | 23100 Providence Dr, Suite 210, Southfield, MI 48075-3667 | 2010-09-09 |
| 1427387497 | Village Center Physical Therapy LLC | Physical Therapist | 23100 Providence Dr, Suite 135, Southfield, MI 48075-3646 | 2009-12-21 |
| 1831342914 | Home Visiting Doctors, Pllc | Community Health Worker | 23100 Providence Dr, Ste # 152, Southfield, MI 48075-3646 | 2008-11-03 |
| 1407018351 | New Center Rehabilitation, Inc | Physical Therapist | 23100 Providence Dr, Suite 135, Southfield, MI 48075-3646 | 2008-07-01 |
| 1508067976 | Official Home Health Services, Inc. | Home Health | 23100 Providence Dr, Suite # 152, Southfield, MI 48075-3646 | 2007-05-31 |
| 1558488783 | Victor Jayasundera | Specialist | 23100 Providence Dr, Suite 135, Southfield, MI 48075-3646 | 2007-03-23 |
| 1104915511 | Universal Home Health Care,inc. | Home Health | 23100 Providence Dr, Suite# 226, Southfield, MI 48075-3646 | 2006-10-12 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855667 | Joshua Boulter | Radiology | 2250 Providence Drive, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-11 |
| 1679197693 | Shyam Amin | Radiology | Academic Internal Medicine 2 2250 Providence Dr, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-05 |
| 1871116509 | Anthony Diebes | Radiology | 16001 W 9 Mile Rd Bldg 4th, Southfield, MI 48075-4818 | 2020-05-28 |
| 1548823800 | Alexander Paul Kaechele | Radiology | 16001 West 9 Mile Road, Suite #416, Southfield, MI 48075-4818 | 2019-04-22 |
| 1023572831 | Proscan Imaging Southfield Pllc | Radiology | 29877 Telegraph Rd # 11, Southfield, MI 48034-1332 | 2019-01-25 |
| 1083052377 | Rani Bashiti | Radiology | 16001 W. 9 Mild Rd, Southfield, MI 48075 | 2013-06-07 |
| 1740583145 | Silver Pine Imaging LLC | Radiology | 20475 W 10 Mile Rd, Southfield, MI 48075-6105 | 2010-12-08 |
| 1639497274 | Sentinel Health Staffing LLC | Radiology | 29155 Northwestern Hwy Ste 642, Southfield, MI 48034-1011 | 2010-05-06 |
| 1992866438 | Osteoporosis Testing Centers Inc | Radiology | 26206 W 12 Mile Road, Ste 103, Southfield, MI 48034 | 2006-12-12 |
| 1053428433 | Norberto Andaya Sugayan | Radiology | 5000 Town Ctr, 605, Southfield, MI 48075-1110 | 2006-08-23 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on SOUTHFIELD RADIOLOGY ASSOCIATES PLLC.
| 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.