National Provider Identifier Database

GREAT LAKES RADIOLOGY PLLC
Radiography Radiologic Technologist

A radiologic technologist who specializes in radiography (also known as x-rays) and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of radiographs, exam techniques, equipment protocols, radiation safety, and patient care.


Contact Information

GREAT LAKES RADIOLOGY PLLC
461 WEST HURON
PONTIAC, MI48341
Phone: 248-857-7200
Fax:
Website:
Specialty Taxonomy Code
* Radiography Radiologic Technologist 2471C3402X

* Indicates primary specialty

NPI Profile & details for GREAT LAKES RADIOLOGY PLLC

NPI Number 1154704948
Legal business name
LBN
GREAT LAKES RADIOLOGY PLLC
Authorized official VENICAT RUDRARAJU - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/30/2015
Last updated 06/30/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • MI License #: 4301067927

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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