NPIMap

Organization Active NPI

Michigan Visiting Physicians

Doing business as Great Lakes Portable Diagnostics

  • Radiologic Technologist
  • Flint, MI
National Provider Identifier
1841522141
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
429780 Issued in MI
Legal business name
MICHIGAN VISITING PHYSICIANS
Doing business as
Great Lakes Portable Diagnostics
Practice address
6240 Rashelle Dr
Suite 103
Flint, MI 48507-3934
Phone
(586) 279-3250
NPI assigned
Feb 11, 2010
Last updated
Feb 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Ram Gunabalan, M.D.
Title
Owner
Phone
(586) 279-9850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X 429780 MI Primary

Addresses

Primary practice location

6240 Rashelle Dr
Suite 103
Flint, MI 48507-3934

Mailing address

6240 Rashelle Dr
Suite 103
Flint, MI 48507-3934

Other names 1

  • Great Lakes Portable Diagnostics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1841522141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 RASHELLE DR",
            "address_2": "SUITE 103",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 RASHELLE DR",
            "address_2": "SUITE 103",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073934",
            "telephone_number": "586-279-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN VISITING PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "GUNABALAN",
        "authorized_official_first_name": "RAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-279-9850",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "MI",
            "license": "429780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Portable Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.