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General NPI Number Information
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NPI Number | 1407250277
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Entity Type | Organization
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Legal Business Name | SUMMIT IMAGING INC
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 24800 SE STARK ST
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City | GRESHAM
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State | OR
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Zip | 97030-3378
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Country | US
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Telephone | 503-674-1122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 547
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City | CORVALLIS
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State | OR
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Zip | 97339-0547
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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 | BUSINESS CONTACT/RADIOLOGIST
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Name | STEVEN URMAN
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Credential | M.D., P.H.D
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Telephone | 503-674-1122
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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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