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General NPI Number Information
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NPI Number | 1053833194
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Entity Type | Organization
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Legal Business Name | CROWN RADIOLOGY ASSOCIATES
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5371 72ND AVE
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City | SCHERERVILLE
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State | IN
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Zip | 46375-5352
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Country | US
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Telephone | 219-756-4600
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Fax | 219-756-5000
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Provider Business Mailing Address
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Address Line | 5371 72ND AVE
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City | SCHERERVILLE
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State | IN
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Zip | 46375-5352
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Country | US
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Telephone | 219-756-4600
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EMMANUEL AIYEVBEKPEN OSAGIEDE
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Credential | MD
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Telephone | 219-756-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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