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Eastland Diagnostic Pc
Radiology Clinic/Center in Roseville, Michigan
NPI 1629119649

Eastland Diagnostic Pc is a Radiology Clinic/Center based in Roseville, MI and is specialized in Radiology. Eastland Diagnostic Pc practices in Roseville, MI. The NPI Number for Eastland Diagnostic Pc is 1629119649 and holds a License No. 4301032665 (Michigan).

The current practice location address for Eastland Diagnostic Pc is 25710 Kelly Rd, Roseville, MI and can be reached out via phone at 586-779-4610 and via fax at 586-779-0003.

Location: 25710 Kelly Rd, Roseville, MI, 48066-4959
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629119649
Provider Name
Eastland Diagnostic Pc
Credential
Provider Entity Type
Organization
Address
25710 Kelly Rd, Roseville, MI, 48066-4959
Phone Number
586-779-4610
Fax Number
586-779-0003
Provider Enumeration Date
02/11/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1376494 05 MI
3005041671 01 MI BLUECARE NETWORK HMO
institution
Provider Business Practice Location Address Details
Address
25710 Kelly Rd
City
Roseville
State
Michigan
Zip
48066-4959
Phone Number
586-779-4610
Fax Number
586-779-0003
person
Provider Business Mailing Address Details
Address
25710 Kelly Rd
City
Roseville
State
Michigan
Zip
48066-4959
Phone Number
586-779-4610
Fax Number
586-779-0003
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Radiology
Taxonomy
261QR0200X
License No.
4301032665 (Michigan)
Definition
Definition to come...
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