Provider Demographics
NPI:1669711719
Name:MOBILE DIAGNOSTICS TESTING INC
Entity type:Organization
Organization Name:MOBILE DIAGNOSTICS TESTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NAGIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-613-5315
Mailing Address - Street 1:1094 SATTERLEE RD
Mailing Address - Street 2:STE A
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3154
Mailing Address - Country:US
Mailing Address - Phone:248-987-2800
Mailing Address - Fax:
Practice Address - Street 1:1094 SATTERLEE RD
Practice Address - Street 2:STE A
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-3154
Practice Address - Country:US
Practice Address - Phone:248-987-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-10
Last Update Date:2014-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty