Provider Demographics
NPI:1508994880
Name:MAUMEE BAY IMAGING CONSULTANTS, INC.
Entity Type:Organization
Organization Name:MAUMEE BAY IMAGING CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOUNTRAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-450-0079
Mailing Address - Street 1:4629 CINNAMON LANE
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560
Mailing Address - Country:US
Mailing Address - Phone:419-471-0048
Mailing Address - Fax:419-471-1307
Practice Address - Street 1:4629 CINNAMON LANE
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560
Practice Address - Country:US
Practice Address - Phone:419-471-0048
Practice Address - Fax:419-471-1307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty