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General NPI Number Information
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NPI Number | 1407520380
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Entity Type | Organization
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Legal Business Name | DISCOVERY IMAGING CENTER
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 8522 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1827
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Country | US
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Telephone | 414-736-9943
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Fax | 414-539-3222
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Provider Business Mailing Address
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Address Line | 8522 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1827
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Country | US
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Telephone | 414-763-9949
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Fax | 414-539-3222
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | TAMARA CONNER
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Credential |
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Telephone | 414-304-9132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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