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General NPI Number Information
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NPI Number | 1033142146
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC IMAGING ASSOCIATES LTD
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 232 S WOODS MILL RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3406
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Country | US
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Telephone | 314-434-1500
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Fax | 314-548-4748
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Provider Business Mailing Address
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Address Line | 13209 CORPORATE EXCHANGE DR
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City | BRIDGETON
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State | MO
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Zip | 63044-3721
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Country | US
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Telephone | 314-471-8323
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Fax | 314-548-4748
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Authorized Official
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Title or Position | CREDENTIALING
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Name | JEANIE SUMMERS
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Credential |
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Telephone | 314-471-8323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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