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General NPI Number Information
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NPI Number | 1194476085
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Entity Type | Organization
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Legal Business Name | MKMI CLEVELAND, LLC
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 515 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44114-2234
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Country | US
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Telephone | 646-362-2007
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Fax |
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Provider Business Mailing Address
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Address Line | 515 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44114-2234
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER OF MKMI CLEVELAND
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Name | MR. WILLIAM MAXWELL KUCERA
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Credential | B.S. CS STANFORD
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Telephone | 440-655-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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