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General NPI Number Information
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NPI Number | 1235523762
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Entity Type | Organization
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Legal Business Name | A&E DIAGNOSTIC IMAGING, LLC
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 5363 COMMERCE BLVD
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City | CROWN POINT
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State | IN
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Zip | 46307-5325
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Country | US
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Telephone | 317-441-4460
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Fax | 219-756-5000
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Provider Business Mailing Address
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Address Line | 5363 COMMERCE BLVD
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City | CROWN POINT
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State | IN
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Zip | 46307-5325
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Country | US
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Telephone | 317-441-4460
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Fax | 219-756-4600
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. EMMANUEL A OSAGIEDE
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Credential | MD
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Telephone | 317-441-4460
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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 | 01061082A
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License Number State | IN
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