Provider Demographics
NPI:1508860206
Name:BIO-MAGNETIC RESONANCE INC
Entity Type:Organization
Organization Name:BIO-MAGNETIC RESONANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNABALAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-583-8922
Mailing Address - Street 1:30781 STEPHENSON HWY
Mailing Address - Street 2:
Mailing Address - City:MADISON HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1618
Mailing Address - Country:US
Mailing Address - Phone:248-583-8922
Mailing Address - Fax:248-583-8969
Practice Address - Street 1:30781 STEPHENSON HWY
Practice Address - Street 2:
Practice Address - City:MADISON HTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1618
Practice Address - Country:US
Practice Address - Phone:248-583-8922
Practice Address - Fax:248-583-8969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1047544408Medicaid
MIP00295133OtherRR MEDICARE DR BIXLER
MIG85261Medicare UPIN
MIG34162Medicare UPIN
MIG19248Medicare UPIN
MIE40929Medicare UPIN
MI0P30680Medicare ID - Type UnspecifiedMEDICARE IDTF
MI1047544408Medicaid
MIC05683Medicare UPIN