Healthcare Provider Details
I. General information
NPI: 1235188376
Provider Name (Legal Business Name): COMPREHENSIVE IMAGING ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2006
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1201 S MAIN ST
CROWN POINT IN
46307-8481
US
IV. Provider business mailing address
55 E 86TH AVE PO BOX 10645
MERRILLVILLE IN
46410-6382
US
V. Phone/Fax
- Phone: 219-757-6320
- Fax: 219-738-6714
- Phone: 219-769-1670
- Fax: 219-738-6714
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOHAMMED
ABBAS
Title or Position: PRESIDENT
Credential: MD
Phone: 219-769-1670