Basic Information
| Provider Information | |||||||||
| NPI: | 1225413446 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRECISION DIAGNOSTICS AND IMAGING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 S SAGINAW ST | ||||||||
| Address2: | SUITE 1651 | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485072677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107328336 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 S SAGINAW ST | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485072677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107328336 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2015 | ||||||||
| LastUpdateDate: | 07/29/2015 | ||||||||
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| AuthorizedOfficialLastName: | BAWAHAB | ||||||||
| AuthorizedOfficialFirstName: | ATIF | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 9795747109 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.