Provider Demographics
NPI:1649418211
Name:NDS RADIOLOGY INC.
Entity Type:Organization
Organization Name:NDS RADIOLOGY INC.
Other - Org Name:NATIONAL DIAGNOSTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KETSLAKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-476-6980
Mailing Address - Street 1:28700 CABOT DR STE 500
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2949
Mailing Address - Country:US
Mailing Address - Phone:248-476-6980
Mailing Address - Fax:248-476-7462
Practice Address - Street 1:28700 CABOT DR STE 500
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2949
Practice Address - Country:US
Practice Address - Phone:248-476-6980
Practice Address - Fax:248-476-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty