Doctor Name: | JAN L MOURELATOS |
NPI Number: | 1003895228 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 4301052862 |
Business Practice Address: | 36175 Harper Ave Clinton Township, MI - 480353274 |
Business Phone Number: | 5867413772 |
Business Fax Number: | 5867414604 |
Mailing Address: | 36175 Harper Ave, CLINTON TOWNSHIP |
State: | MI |
Postal Code: | 480353274 |
Phone Number: | 5867413772 |
Fax Number: | 5867414604 |
NPI Enumeration Date: | 01/16/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 4301052862 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |