Psi Radiological Service, Inc

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

24834 Issued in MI

Legal business name

PSI RADIOLOGICAL SERVICE, INC

Practice address

8529 E 8 Mile Rd
Warren, MI 48089-3067

Phone

(586) 619-7025

Fax

(586) 619-7267

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Victor Collado, M.D,. PH.D

Title

Radiologist

Phone

(313) 962-2133

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303516800000",
    "number": "1508945635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264324",
            "telephone_number": "313-962-2133",
            "fax_number": "313-962-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8529 E 8 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480893067",
            "telephone_number": "586-619-7025",
            "fax_number": "586-619-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSI RADIOLOGICAL SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-04-23",
        "status": "A",
        "authorized_official_last_name": "COLLADO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "313-962-2133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D,. PH.D"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "24834",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "MI",
            "license": "24834",
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "MI",
            "license": "24834",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CROSSOVER",
            "identifier": "0H228030",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114483540",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Warren, MI
• Providers in Warren, MI by specialty
• Radiology Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2011; 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.