Healthcare Provider Details

I. General information

NPI: 1912908849
Provider Name (Legal Business Name): MILLENNIUM RADIOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4983 DELHI AVE SUITE 6
CINCINNATI OH
45238-5380
US

IV. Provider business mailing address

PO BOX 636298
CINCINNATI OH
45263-6298
US

V. Phone/Fax

Practice location:
  • Phone: 513-347-7237
  • Fax: 513-347-6567
Mailing address:
  • Phone: 513-347-7237
  • Fax: 513-347-6567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA E ZIPPERER-DAVIS
Title or Position: CEO
Credential:
Phone: 513-347-7237