Provider Demographics
NPI:1790027555
Name:SUMMIT DIAGNOSTIC SERVICES PLLC
Entity Type:Organization
Organization Name:SUMMIT DIAGNOSTIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:248-593-9780
Mailing Address - Street 1:19699 E 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1655
Mailing Address - Country:US
Mailing Address - Phone:586-445-9900
Mailing Address - Fax:
Practice Address - Street 1:8560 N SILVERY LN
Practice Address - Street 2:SUITE 202
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-4515
Practice Address - Country:US
Practice Address - Phone:313-581-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)