Genesis MD Diagnostic Imaging PC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

GENESIS MD DIAGNOSTIC IMAGING PC

Practice address

8560 N Silvery LN Ste 101
Dearborn Heights, MI 48127-4516

Phone

(313) 581-3255

Fax

(313) 581-3755

NPI assigned

May 6, 2019

Last updated

May 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edrick Ferguson, M.D.

Title

Owner

Phone

(313) 581-3255

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1336704311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8560 N SILVERY LN STE 101",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274516",
            "telephone_number": "313-581-3255",
            "fax_number": "313-581-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8560 N SILVERY LN STE 101",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274516",
            "telephone_number": "313-581-3255",
            "fax_number": "313-581-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MD DIAGNOSTIC IMAGING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "EDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-581-3255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Garner
• Latavia Garrett
• Gary Gazella, MD
• Dania Gelan
• Genesis Healthcare
• Genesis MD, PLLC
• Gentle Care Dental
• Genuine Home Care
• Get Well Urgent Care Dearborn Heights PLC
• Ghaleb F Hatem, MD, PC

• Mobile Radiology Clinic/Center in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Mobile Radiology Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.