NPIMap

Organization Active NPI

Mid Michigan Diagnostic Corp

  • Diagnostic Radiology Physician
  • Burton, MI
National Provider Identifier
1093962342
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MID MICHIGAN DIAGNOSTIC CORP
Practice address
1513 S Center Rd
Burton, MI 48509-1728
Phone
(810) 742-8770
NPI assigned
Aug 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Authorized official

Name
Mr. Zakwan Aboudane
Title
Owner
Phone
(810) 742-8770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X MI Primary

Addresses

Primary practice location

1513 S Center Rd
Burton, MI 48509-1728

Mailing address

3400 Fleckenstein Rd
Suite D
Flint, MI 48507-3043
Phone (810) 742-8770

National Provider Directory

National Provider Directory

Locations

1409 S Graham Rd
Ste B
Flint, MI 48532
Phone (810) 606-0656

1513 S Center Rd
Flint, MI 48509
Phone (810) 742-5700

1794 N Lapeer Rd
Lapeer, MI 48446
Phone (810) 245-1800

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1093962342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 FLECKENSTEIN RD",
            "address_2": "SUITE D",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073043",
            "telephone_number": "810-742-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091728",
            "telephone_number": "810-742-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MICHIGAN DIAGNOSTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "ABOUDANE",
        "authorized_official_first_name": "ZAKWAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-742-8770",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.