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NPI Code Detail

MEDICARE: SUMMIT RADIOLOGY P C

MEDICARE: SUMMIT RADIOLOGY P C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0204XVascular & Interventional Radiology Physician
22085R0202XDiagnostic Radiology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CC0677OTHERINMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073584587
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT RADIOLOGY P C
Provider Business Mailing Address
First Line : 7221 ENGLE RD STE 220
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-2233
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Provider Business Practice Location Address
First Line : 7221 ENGLE RD STE 220
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-2233
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Authorized Official
Title or Position : PRESIDENT
Name : DR. DANIEL BRANAM
Credential : MD
Telephone Number : 260-432-1568
Provider Enumeration Date : 02/01/2006
Last Update Date : 08/14/2025

Similar Medicare Providers

1770563215 — DR. MICHAEL S VALADE M.D.
Practice Location Address:
7221 ENGLE RD STE 220
FORT WAYNE, IN
46804-2233
Practice Phone: 260-432-1568
Practice Fax: 260-432-4969
1154392363 — DR. MARC ANDREW THOMAS MD
Practice Location Address:
7221 ENGLE RD STE 220
FORT WAYNE, IN
46804-2233
Practice Phone: 260-432-1568
Practice Fax: 260-432-4969
1124099395 — DR. RANDALL JOSEPH PHILLIPS MD
Practice Location Address:
7221 ENGLE RD STE 220
FORT WAYNE, IN
46804-2233
Practice Phone: 260-432-1568
Practice Fax: 260-432-4969
1831160001 — DR. JOHN NOVAK PASALICH MD
Practice Location Address:
7221 ENGLE RD STE 220
FORT WAYNE, IN
46804-2233
Practice Phone: 260-469-8223
Practice Fax: 260-469-8201
1619948726 — DR. MICHAEL EARLY PARKER MD
Practice Location Address:
7221 ENGLE RD STE 220
FORT WAYNE, IN
46804-2233
Practice Phone: 260-432-1568
Practice Fax: 260-432-4969
1992776181 — DR. PAMELA LEE STRANGE MD
Practice Location Address:
7221 ENGLE RD STE 220
FORT WAYNE, IN
46804-2233
Practice Phone: 260-432-1568
Practice Fax: 260-432-4969

Directions to “SUMMIT RADIOLOGY P C ” Practice Location

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