Mid Michigan Diagnostic Corp

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MID MICHIGAN DIAGNOSTIC CORP

Practice address

2137 W M 61
Gladwin, MI 48624-8463

Phone

(810) 742-8770

Fax

(810) 742-8772

NPI assigned

Aug 15, 2008

Organization subpart

No

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 2

Addresses

Other names 1

• Mid MIchigan Diagnostics Other name

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1306092887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091728",
            "telephone_number": "810-742-8770",
            "fax_number": "810-742-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 W M 61",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486248463",
            "telephone_number": "810-742-8770",
            "fax_number": "810-742-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MICHIGAN DIAGNOSTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-15",
        "last_updated": "2009-04-22",
        "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": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid MIchigan Diagnostics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeffrey R McReynolds, CNMT
• Destiney Rose McWilliams
• Trisha Ann Meier, COTAL
• Sara Marie Miceli-Sorensen, LMSW
• Michigan Emergency Physicians LLP
• Mid-Michigan Dental Associates PLC Gladwin
• Midland Radiology Associates PC
• Midmichigan Cardiology, PC
• Midmichigan Gladwin Pines
• Midmichigan Gladwin Pines

• Diagnostic Radiology Physician in Gladwin, MI
• Providers in Gladwin, 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 Apr 22, 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.