Provider Demographics
NPI:1689904732
Name:ADVANCED MOBILE SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED MOBILE SERVICES, LLC
Other - Org Name:ADVANCED DIAGNOSTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-709-7800
Mailing Address - Street 1:1220 E 9 MILE RD # B
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1972
Mailing Address - Country:US
Mailing Address - Phone:888-258-6825
Mailing Address - Fax:248-544-4681
Practice Address - Street 1:1220 E 9 MILE RD # B
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1972
Practice Address - Country:US
Practice Address - Phone:888-258-6825
Practice Address - Fax:248-544-4681
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NUWELL COMPANIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-12
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIB2267E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI2443Medicare PIN