Provider Demographics
NPI:1275608747
Name:RADIOLOGY OF SOUTH CENTRAL MICHIGAN, PC
Entity Type:Organization
Organization Name:RADIOLOGY OF SOUTH CENTRAL MICHIGAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-437-5149
Mailing Address - Street 1:168 S HOWELL ST
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-2040
Mailing Address - Country:US
Mailing Address - Phone:517-437-5149
Mailing Address - Fax:
Practice Address - Street 1:168 S HOWELL ST
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-2040
Practice Address - Country:US
Practice Address - Phone:517-437-5149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI022957OtherMIDWEST HEALTH PLAN
MINC009821OtherM-CARE
MI0995475OtherHEALTHPLUS OF MI
MI1009812OtherCALHOUN HEALTH PLAN
MI1009812OtherJACKSON HEALTH PLAN
MI14009OtherPRIORITY HEALTH
MIDA2187OtherRAILROAD MEDICARE
MINC009821OtherKIDS CARE OF MI
MI0C01011OtherBLUE CROSS BLUE SHIELD
MI022957OtherMIDWEST HEALTH PLAN
MI=========050OtherCOMMUNITY CHOICE OF MI