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General NPI Number Information
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NPI Number | 1316105430
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Entity Type | Organization
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Legal Business Name | MEDICAL IMAGING NETWORK
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 819 MCKAY CT
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City | BOARDMAN
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State | OH
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Zip | 44512-5713
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Country | US
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Telephone | 330-726-2071
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Fax | 330-726-9007
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Provider Business Mailing Address
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Address Line | 819 MCKAY CT
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City | BOARDMAN
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State | OH
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Zip | 44512-5713
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Country | US
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Telephone | 330-726-2071
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Fax | 330-726-9007
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ALBERT M BLEGGI
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Credential | M.D.
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Telephone | 330-726-9006
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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 | 35050931
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License Number State | OH
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