Basic Information
Provider Information
NPI: 1851493100
EntityType: 2
ReplacementNPI:  
OrganizationName: OAKLAND IMAGING SERVICES, PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 28300 ORCHARD LAKE RD
Address2:  
City: FARMINGTON HILLS
State: MI
PostalCode: 483343704
CountryCode: US
TelephoneNumber: 2487374030
FaxNumber: 2487370636
Practice Location
Address1: 28300 ORCHARD LAKE RD
Address2:  
City: FARMINGTON HILLS
State: MI
PostalCode: 483343704
CountryCode: US
TelephoneNumber: 2487374030
FaxNumber: 2487370636
Other Information
ProviderEnumerationDate: 09/05/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RONTAL
AuthorizedOfficialFirstName: EUGENE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 2487374030
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
247100000X  Y193400000X SINGLE SPECIALTY GROUPTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist 

No ID Information.


Home