Healthcare Provider Details

I. General information

NPI: 1447203849
Provider Name (Legal Business Name): MIDWEST ULTRASOUND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 KENWOOD CROSSING WAY SUITE 225
CINCINNATI OH
45236-3668
US

IV. Provider business mailing address

8250 KENWOOD CROSSING WAY SUITE 225
CINCINNATI OH
45236-3668
US

V. Phone/Fax

Practice location:
  • Phone: 513-936-0444
  • Fax:
Mailing address:
  • Phone: 513-936-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number620346
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number620346
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number620346
License Number StateOH

VIII. Authorized Official

Name: MR. MICHAEL W SCHWEBLER
Title or Position: COO
Credential:
Phone: 513-936-0444