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General NPI Number Information
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NPI Number | 1912900341
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Entity Type | Organization
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Legal Business Name | SCIENTIFIC MEDICAL IMAGING, INC.
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 540 PARMALEE AVE SUITE 100
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City | YOUNGSTOWN
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State | OH
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Zip | 44510
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Country | US
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Telephone | 330-746-1231
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Fax | 330-746-3827
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Provider Business Mailing Address
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Address Line | 540 PARMALEE AVE SUITE 100
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City | YOUNGSTOWN
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State | OH
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Zip | 44510-1605
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Country | US
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Telephone | 330-746-1231
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Fax | 330-746-3827
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHANDER M KOHLI
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Credential | M.D.
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Telephone | 330-746-1231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35-03-4176 K
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License Number State | OH
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