Provider Demographics
NPI:1235182932
Name:MIDMICHIGAN REGIONAL IMAGING
Entity Type:Organization
Organization Name:MIDMICHIGAN REGIONAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-662-2111
Mailing Address - Street 1:2618 W SUGNET RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2647
Mailing Address - Country:US
Mailing Address - Phone:989-839-3314
Mailing Address - Fax:989-839-1563
Practice Address - Street 1:4714 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9434
Practice Address - Country:US
Practice Address - Phone:989-662-2111
Practice Address - Fax:989-662-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N57700Medicare PIN