Provider Demographics
NPI:1558409649
Name:EASTPOINTE RADIOLOGISTS, PC
Entity Type:Organization
Organization Name:EASTPOINTE RADIOLOGISTS, PC
Other - Org Name:GROSSE POINTE PHYSICIANS XRAY CENTER, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-741-3772
Mailing Address - Street 1:21003 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1333
Mailing Address - Country:US
Mailing Address - Phone:586-741-3772
Mailing Address - Fax:586-741-4604
Practice Address - Street 1:21003 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1333
Practice Address - Country:US
Practice Address - Phone:313-881-0411
Practice Address - Fax:313-881-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H26188OtherFEDERAL BLACK LUNG
MI0H26188OtherBCBS OF MICHIGAN
MI320433OtherULTICARE HMO OF MICHIGAN
MI506044OtherCARE CHOICES HMO
MI300H261880OtherBCN ADVANTAGE
MI495680OtherHEALTH ALLIANCE PLAN
MIC20438OtherRAILROAD MEDICARE
MISJ820005OtherM-CARE
MI1111920004OtherWELLNESS PLAN OF MICHIGAN
MISJ820005OtherM-CARE SENIOR
MI0H26188OtherFEDERAL BLACK LUNG
MI=========OtherHEALTH NET FEDERAL SERVIC
MI300H261880OtherBCN ADVANTAGE
MI495680OtherHEALTH ALLIANCE PLAN