Provider Demographics
NPI:1659398519
Name:HURON VALLEY RADIOLOGY PC
Entity Type:Organization
Organization Name:HURON VALLEY RADIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIPSKI-MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-712-8350
Mailing Address - Street 1:5333 MCAULEY DR
Mailing Address - Street 2:SUITE 6016
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1014
Mailing Address - Country:US
Mailing Address - Phone:734-712-8350
Mailing Address - Fax:734-712-8351
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:SUITE 6016
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1014
Practice Address - Country:US
Practice Address - Phone:734-712-8350
Practice Address - Fax:734-712-8351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700H160030OtherBCBS OF MICHIGAN
MI0H16003Medicare PIN
MI700H160030OtherBCBS OF MICHIGAN