Provider Demographics
NPI:1144303710
Name:SUPERIOR VIEW RADIOLOGY PLC
Entity type:Organization
Organization Name:SUPERIOR VIEW RADIOLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:906-225-0122
Mailing Address - Street 1:308 CLEVELAND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-1837
Mailing Address - Country:US
Mailing Address - Phone:906-204-2407
Mailing Address - Fax:906-225-0135
Practice Address - Street 1:500 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1452
Practice Address - Country:US
Practice Address - Phone:906-225-0122
Practice Address - Fax:906-225-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4464170Medicaid
MI4833513Medicaid
MI4464170Medicaid
MIB44439Medicare UPIN
MI4833513Medicaid
MI0P26360002Medicare ID - Type UnspecifiedLARA