Provider Demographics
NPI:1760786107
Name:INNERSIGHT DIAGNOSTICS
Entity Type:Organization
Organization Name:INNERSIGHT DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:W
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA,,RDCS(E)
Authorized Official - Phone:313-434-6057
Mailing Address - Street 1:9572 CHATHAM
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48239-1306
Mailing Address - Country:US
Mailing Address - Phone:313-434-6057
Mailing Address - Fax:
Practice Address - Street 1:9572 CHATHAM
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48239-1306
Practice Address - Country:US
Practice Address - Phone:313-434-6057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TURNER UNIVERSAL INDUSTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Multi-Specialty