| Irfan Mamoun, MD | |
| 
					36175 Harper Ave, Clinton Township, MI 48035-3274  | |
| (586) 741-3772 | |
| Not Available | 
| Full Name | Irfan Mamoun | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 36175 Harper Ave, Clinton Township, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1861637811 | NPI | - | NPPES | 
| 4301038517 | Other | MI | MEDICAL LICENSE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | ME141698 (Florida) | Secondary | 
| 2085R0202X | Radiology - Diagnostic Radiology | 4301038517 (Michigan) | Primary | 
| Entity Name | Columbus Radiology Corp | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1669408159 PECOS PAC ID: 6507754983 Enrollment ID: O20040308000742  | 
| Entity Name | F&s Radiology Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1518299957 PECOS PAC ID: 0244368868 Enrollment ID: O20100628000202  | 
| Entity Name | Mercy Health Physicians Youngstown Specialty Care Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1649892225 PECOS PAC ID: 3476950296 Enrollment ID: O20210921003835  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Irfan Mamoun, MD 22550 Bard Ave, Fairview Park, OH 44126-2907 Ph: (440) 378-4186  | Irfan Mamoun, MD 36175 Harper Ave, Clinton Township, MI 48035-3274 Ph: (586) 741-3772  | 
Kyoung Soo Bae, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604  | |
Michael P. Trpkovski, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-464-0740  | |
Cadie Lee Cunningham,  Radiology Medicare: Not Enrolled in Medicare Practice Location: 38654 Bay Ln, Clinton Township, MI 48038 Phone: 586-854-2533  | |
Rojanandham Samudrala, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604  | |
Mrs. Cynthia Marie Wheeler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604  | |
Anthony P Munaco, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604  | |
Prof. Victor Maldonado, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 36175 Harper Ave, Clinton Township, MI 48035 Phone: 586-741-3772 Fax: 586-741-4604  |