NPIMap

Organization Active NPI

Beaumont Special Radiological Procedures

  • Diagnostic Radiology Physician
  • Royal Oak, MI
National Provider Identifier
1043220205
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BEAUMONT SPECIAL RADIOLOGICAL PROCEDURES
Practice address
3601 W Thirteen Mile Rd
Royal Oak, MI 48073
Phone
(248) 898-6064
Fax
(248) 898-5490
NPI assigned
Aug 9, 2006
Last updated
Jun 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Duane G. Mezwa, MD
Title
Chief of Rad Dept/Program Director
Phone
(248) 898-6064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

3601 W Thirteen Mile Rd
Royal Oak, MI 48073

Mailing address

PO Box 64011
Detroit, MI 48264-0001
Phone (586) 412-4000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 83

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1043220205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64011",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482640001",
            "telephone_number": "586-412-4000",
            "fax_number": "586-412-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W THIRTEEN MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-898-6064",
            "fax_number": "248-898-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT SPECIAL RADIOLOGICAL PROCEDURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "MEZWA",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CHIEF OF RAD DEPT/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "248-898-6064",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.