Provider Demographics
NPI:1992899660
Name:MONROE RADIOLOGY PC
Entity type:Organization
Organization Name:MONROE RADIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-240-8400
Mailing Address - Street 1:718 N. MACOMB
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161
Mailing Address - Country:US
Mailing Address - Phone:734-240-8400
Mailing Address - Fax:
Practice Address - Street 1:718 N MACOMB ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-7815
Practice Address - Country:US
Practice Address - Phone:734-240-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIRA820059OtherM-CARE
MI023585OtherMIDWEST HEALTHPLAN
MI29694OtherCOMMUNITY CHOICE OF MI
MI04437OtherPRIORITY HEALTH
MI707535OtherFAMILY HEALTH PLAN
MICI5353OtherRAILROAD MEDICARE
MI04849OtherPARAMOUNT HEALTHCARE
MI0E81027OtherBLUE CROSS BLUE SHIELD
MI1528103OtherUNITED MINE WORKERS
MI116830OtherCARE CHOICES
MI13596600OtherUS DEPT OF LABOR WC
MI1528103OtherUNITED MINE WORKERS