Provider Demographics
NPI:1942392196
Name:DOCTORS DIAGNOSTIC CENTER PC
Entity type:Organization
Organization Name:DOCTORS DIAGNOSTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-264-1800
Mailing Address - Street 1:2405 E 14 MILE RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5961
Mailing Address - Country:US
Mailing Address - Phone:586-264-6079
Mailing Address - Fax:586-264-2039
Practice Address - Street 1:2405 E 14 MILE RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5961
Practice Address - Country:US
Practice Address - Phone:586-264-6079
Practice Address - Fax:586-264-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1922089473OtherNPI LERCHIN
MI1063490894OtherNPI GOLDSTEIN
MI1346212800OtherNPI BORIN
MA1356349082OtherNPI SILVERMAN
MI1376540286OtherNPI KACHADURIAN
MI1588661391OtherNPI ELKISS
MI0F37180OtherBCN GROUP BILL PIN
MI1083698997OtherNPI BERG
MI1437181146OtherNPI MELLEN
MI1891751509OtherNPI KOVAN
MI0F37180OtherBCN GROUP BILL PIN
MI1083698997OtherNPI BERG
MI1437181146OtherNPI MELLEN
MI0M80520Medicare PIN
MI0E06355Medicare PIN