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General NPI Number Information
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NPI Number | 1568173409
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Entity Type | Organization
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Legal Business Name | ADVANCED DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 8649 W BROWN DEER RD
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City | MILWAUKEE
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State | WI
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Zip | 53224-2114
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Country | US
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Telephone | 414-801-8609
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Fax |
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Provider Business Mailing Address
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Address Line | 8649 W BROWN DEER RD
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City | MILWAUKEE
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State | WI
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Zip | 53224-2114
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Country | US
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Telephone | 414-801-8609
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Fax |
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Authorized Official
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Title or Position | OWNER/RADIOLOGIST
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Name | SYED ASHTER RIZVI
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Credential | MD
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Telephone | 414-801-8609
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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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