Active NPI
Paul Petre MD PC
Doing business as Great Lakes Portable Diagnostics
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Warren, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Legal business name
- PAUL PETRE MD PC
- Doing business as
- Great Lakes Portable Diagnostics
- Practice address
- 28800 Ryan Rd
Suite 300
Warren, MI 48092-4272 - Phone
- (586) 573-6400
- Fax
- (586) 573-1918
- NPI assigned
- Nov 21, 2008
- Last updated
- Nov 21, 2008
- Organization subpart
- Yes
- Parent organization
- PAUL PETRE MD PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Petre, MD
- Title
- President
- Phone
- (586) 573-6400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X | Primary |
Addresses
Primary practice location
28800 Ryan Rd
Suite 300
Warren, MI 48092-4272
Mailing address
30781 Stephenson Hwy
Madison HTS, MI 48071-1618
Phone (248) 284-2316
Other names 1
- Great Lakes Portable Diagnostics
National Provider Directory
National Provider Directory- Part of
- Paul Petre MD PC
Locations
28800 Ryan Rd
Ste 300
Warren, MI 48092
Phone (586) 573-6400
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Oak Park, MI
- NPI 1023145232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227225600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1227225600000",
"number": "1750536454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30781 STEPHENSON HWY",
"city": "MADISON HTS",
"state": "MI",
"postal_code": "480711618",
"telephone_number": "248-284-2316",
"fax_number": "248-583-8969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28800 RYAN RD",
"address_2": "SUITE 300",
"city": "WARREN",
"state": "MI",
"postal_code": "480924272",
"telephone_number": "586-573-6400",
"fax_number": "586-573-1918"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAUL PETRE MD PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PAUL PETRE MD PC",
"enumeration_date": "2008-11-21",
"last_updated": "2008-11-21",
"status": "A",
"authorized_official_last_name": "PETRE",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "586-573-6400",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "335V00000X",
"taxonomy_group": "",
"desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Great Lakes Portable Diagnostics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.