Organization · Type 2 NPI

William Beaumont Hospital

Diagnostic Radiology Physician · Royal Oak, MI

NPI number 1104875426 Active

Practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Call (248) 585-8271 Map

Fax (248) 585-8266

Mailing address

26901 Beaumont Blvd, Compliance
Southfield, MI 48033-4716

Specialties and licenses

Taxonomy	Code	License
Diagnostic Radiology Physician Primary	2085R0202X	None listed

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

1,715 other providers at this address

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NPI record

NPI: 1104875426
Entity type: Organization (Type 2)
Issued: May 6, 2006
Last updated: Oct 1, 2021
Status: Active
Subpart: Yes of William Beaumont Hospital

Other names

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Beaumont Professional Services Dxradiology · doing business as
Beaumont Professional Services Dxradiology · doing business as

Authorized official

Lee Ann Odom
President Shared Services
(947) 522-3326

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104875426

William Beaumont Hospital's National Provider Identifier is 1104875426, issued on May 6, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Royal Oak, MI. The record was last updated on Oct 1, 2021.