GRAND TRAVERSE RADIOLOGISTS PC NPI 1760404891

NPI Information

NPI: 1760404891
Provider Name: GRAND TRAVERSE RADIOLOGISTS PC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
1105 SIXTH ST
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 935-0497
Get Directions

GRAND TRAVERSE RADIOLOGISTS PC is a diagnostic radiology radiology in Traverse City, MI. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. GRAND TRAVERSE RADIOLOGISTS PC NPI is 1760404891. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1105 SIXTH ST
TRAVERSE CITY, MI
ZIP 49684-345
Phone: (231) 935-0497

The provider's authorized official is Michelle M Lung .
The authorized official title is President and has the following contact phone number (231) 935-0497.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 4/29/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	280047	OTHER	MICHIGAN	FEDERAL BLACK LUNG
2	XX00308	OTHER	MICHIGAN	HEALTHPLUS OF MI
3	10399	OTHER	MICHIGAN	M-CARE
4	4055	OTHER	MICHIGAN	PRIORITY HEALTH
5	53556A	OTHER	MICHIGAN	HEALTH ALLIANCE PLAN
6	803002	OTHER	MICHIGAN	COMMUNITY CARE PLAN
7	008081	OTHER	MICHIGAN	MIDWEST HEALTH PLAN
8	0B87605	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD
9	12088500	MEDICAID	WISCONSIN
10	134232100	OTHER	MICHIGAN	US DEPT. OF LABOR
11	N16010	OTHER	MICHIGAN	NORTHMED HMO
12	CA3471	OTHER	MICHIGAN	RAILROAD MEDICARE
13	104756	OTHER	MICHIGAN	CARE CHOICES
14	27837	OTHER	MICHIGAN	COMMUNITY CHOICE MI
15	104756	OTHER	MICHIGAN	PREFERRED CHOICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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