Provider Demographics
NPI:1558378455
Name:GREATER FLINT IMAGING CENTER
Entity Type:Organization
Organization Name:GREATER FLINT IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPARSCHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-235-0668
Mailing Address - Street 1:PO BOX 5329
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-0329
Mailing Address - Country:US
Mailing Address - Phone:810-503-4935
Mailing Address - Fax:989-252-8055
Practice Address - Street 1:3273 DAVISON RD STE 3
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-4307
Practice Address - Country:US
Practice Address - Phone:810-245-5675
Practice Address - Fax:810-235-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010425152085N0700X
MI43010317032085N0904X
MI43010341232085R0202X
MI43010315882085R0202X
MI43010570462085R0202X
MI43010346752085R0202X
MI43010377092085R0202X
MI43010469322085R0202X
MI43014069122085R0202X
MI43010371122085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Single Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI300B54778OtherBCBSM COMMON PROVIDER NO.
MIOB54778Medicare ID - Type UnspecifiedCOMMON PROVIDER NUMBER