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General NPI Number Information
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NPI Number | 1730179821
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Entity Type | Organization
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Legal Business Name | NORTHEASTERN HIGH-FIELD MRI, LLC
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 4900 PARKWAY DR SUITE 140
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City | MASON
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State | OH
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Zip | 45040-8429
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Country | US
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Telephone | 513-459-2525
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Fax | 513-459-7555
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Provider Business Mailing Address
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Address Line | 4790 RED BANK EXPY SUITE 128
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City | CINCINNATI
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State | OH
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Zip | 45227-1598
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Country | US
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Telephone | 513-281-3400
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Fax | 513-527-2275
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Authorized Official
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Title or Position | COO
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Name | MICHAEL D. O'BRIEN
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Credential |
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Telephone | 513-281-3400
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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 | 0639IC
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License Number State | OH
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