Provider Demographics
NPI:1922240415
Name:MEDICAL IMAGING NETWORK, PLLC
Entity Type:Organization
Organization Name:MEDICAL IMAGING NETWORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRAKANT
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAPDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:248-538-9524
Mailing Address - Street 1:1727 SAINT JOHNS CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1777
Mailing Address - Country:US
Mailing Address - Phone:248-538-9524
Mailing Address - Fax:248-499-6255
Practice Address - Street 1:1727 SAINT JOHNS CT
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1777
Practice Address - Country:US
Practice Address - Phone:248-538-9524
Practice Address - Fax:248-499-6255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010316932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty