Downriver Cancer Center
Organization Active NPI Radiation Oncology Physician · Brownstown TWP, MI
NPI 1528057692 · NPPES record last updated May 29, 2013
Key facts
- NPI
- 1528057692
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiation Oncology Physician 2085R0001X
- License
- 065057 (MI)
- Legal business name
- DOWNRIVER CANCER CENTER
- Practice address
- 19675 Allen Rd
Brownstown TWP, MI 48183-1021 - Phone
- (734) 479-3311
- Fax
- (734) 479-8009
- NPI assigned
- Oct 20, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Amy Esposito
- Title
- Group Practice Dir.
- Phone
- (313) 916-2803
Member of 1
Practitioners 3
-
Munther I. Ajlouni, M.D.
-
Susan M Laing, MD
-
Samuel Ryu, M.D.
National Provider Directory
Locations
19675 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-3311
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician |
2085R0001X | 065057 | MI | Yes |
| Radiation Oncology Physician |
2085R0001X | 402608 | MI |
Addresses
Primary practice location
19675 Allen Rd
Brownstown TWP, MI 48183-1021
Mailing address
19675 Allen Rd
Brownstown TWP, MI 48183-1021
Phone (734) 479-3311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3156435 | Medicaid | MI | |
| 4476493 | Other | MI | GREAT LAKES HEALTH PLAN |
| OM11130 | Other | MI | HEALTH ALLIANCE PLAN |
| 018870 | Other | MI | MIDWEST HEALTH PLAN |
| 320H210170 | Other | MI | BCBS |
| 4476493 | Medicaid | MI |
Other names
- Josephine Ford Cancer Center
Other providers in Brownstown TWP, MI
- Wael Hussein Dabaja
- Kenneth Jerome Dennis
- Andrew Joseph Dettore
- Jignesh Dhananjay Dhrangadharia
- Discount Drugs LLC
- Downriver Operations, LLC
- Downriver Pediatric Associates P.C.
- Downriver Specialists, P.C.
- Renita Jon Elder-Robinson
- Eleni Callis DDS PLLC
All providers in Brownstown TWP, MI · Radiation Oncology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.