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NPI Code Detail

MEDICARE: CENTRE DIAGNOSTIC IMAGING, PC

MEDICARE: CENTRE DIAGNOSTIC IMAGING, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085B0100XBody Imaging Physician
22085N0904XNuclear Radiology Physician
32085U0001XDiagnostic Ultrasound Physician
42085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306841929
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRE DIAGNOSTIC IMAGING, PC
Provider Business Mailing Address
First Line : PO BOX 197
Second Line :
City : STATE COLLEGE
State : PA
Zip : 16804-0197
Country : US
Telephone Number : 814-235-1526
Fax Number : 814-235-1566
Provider Business Practice Location Address
First Line : 1800 E PARK AVE
Second Line :
City : STATE COLLEGE
State : PA
Zip : 16803-6701
Country : US
Telephone Number : 814-234-6137
Fax Number : 814-234-6795
Authorized Official
Title or Position : PRESIDENT
Name : DR. GREGORY ROSS WEIMER
Credential : MD
Telephone Number : 814-231-7000
Provider Enumeration Date : 06/20/2005
Last Update Date : 05/15/2008

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Directions to “CENTRE DIAGNOSTIC IMAGING, PC ” Practice Location

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