Provider Demographics
NPI:1558963850
Name:TELERADIOLOGY SPECIALISTS OF MICHIGAN, PLLC
Entity Type:Organization
Organization Name:TELERADIOLOGY SPECIALISTS OF MICHIGAN, PLLC
Other - Org Name:TELERADIOLOGY SPECIALISTS OF MICHIGAN, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-819-0808
Mailing Address - Street 1:41000 WOODWARD AVE
Mailing Address - Street 2:SUITE 350, EAST BUILDING
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5092
Mailing Address - Country:US
Mailing Address - Phone:888-819-0808
Mailing Address - Fax:779-666-8065
Practice Address - Street 1:41000 WOODWARD AVE
Practice Address - Street 2:SUITE 350, EAST BUILDING
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5092
Practice Address - Country:US
Practice Address - Phone:888-819-0808
Practice Address - Fax:779-666-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology