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General NPI Number Information
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NPI Number | 1063585628
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Entity Type | Organization
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Legal Business Name | SEVERANCE RADIOLOGY SERVICES, INC.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5 SEVERANCE CIR SUITE 207
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44118-1566
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Country | US
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Telephone | 216-382-7165
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Fax | 216-382-7166
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Provider Business Mailing Address
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Address Line | 5 SEVERANCE CIR SUITE 207
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44118-1566
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Country | US
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Telephone | 216-382-7165
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Fax | 216-382-7166
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ELIZABETH NOLAN
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Credential |
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Telephone | 216-382-7165
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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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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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