Provider Demographics
NPI:1871150987
Name:LUNG DIAGNOSTIC SOLUTIONS
Entity type:Organization
Organization Name:LUNG DIAGNOSTIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:V
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-588-9813
Mailing Address - Street 1:25631 LITTLE MACK AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2108
Mailing Address - Country:US
Mailing Address - Phone:586-588-9813
Mailing Address - Fax:586-588-9814
Practice Address - Street 1:25631 LITTLE MACK AVE STE 202
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081
Practice Address - Country:US
Practice Address - Phone:586-588-9813
Practice Address - Fax:586-588-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty