Provider Demographics
NPI:1548286990
Name:HURON RIVER RADIATION ONCOLOGY SPECIALISTS PC
Entity type:Organization
Organization Name:HURON RIVER RADIATION ONCOLOGY SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-712-3596
Mailing Address - Street 1:PO BOX 995
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-0995
Mailing Address - Country:US
Mailing Address - Phone:734-712-3596
Mailing Address - Fax:734-712-5344
Practice Address - Street 1:5301 EAST HURON RIVER DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-0995
Practice Address - Country:US
Practice Address - Phone:734-712-3595
Practice Address - Fax:734-712-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P07550Medicare ID - Type Unspecified