Southeast Michigan Imaging Services LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SOUTHEAST MICHIGAN IMAGING SERVICES LLC

Practice address

15201 Century Dr
Suite 606
Dearborn, MI 48120-1232

Phone

(313) 427-8660

Fax

(313) 427-8667

NPI assigned

Aug 18, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Eric Ott

Title

Ceo

Phone

(313) 427-8660

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1194191700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15201 CENTURY DR",
            "address_2": "SUITE 606",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201232",
            "telephone_number": "313-427-8660",
            "fax_number": "313-427-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15201 CENTURY DR",
            "address_2": "SUITE 606",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201232",
            "telephone_number": "313-427-8660",
            "fax_number": "313-427-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MICHIGAN IMAGING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-427-8660",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mamoun Mousa Souleiman, MD
• Mark Soutar, LLP
• South Dearborn Pharmacy,Inc
• Abigail Channing Southard, MSN, CNM, C-EFM
• Southeast Michigan Anesthesia Group PLLC
• Southeast Michigan Interventional Pain Specialists
• Southeast Michigan Interventional Pain Specialists
• Southeast Michigan Surgical Hospital, LLC
• Southfield Rehabilitation Company
• Malalda Darlene Sow

• Diagnostic Radiology Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.