MEDICARE: OPEN MRI OF STEUBENVILLE, LTD

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
1	174400000X	Specialist	0549IC	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1861445462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN MRI OF STEUBENVILLE, LTD

Provider Business Mailing Address
First Line	:	2315 SUNSET BLVD
Second Line	:	SUITE D
City	:	STEUBENVILLE
State	:	OH
Zip	:	43952-2496
Country	:	US
Telephone Number	:	740-266-7674
Fax Number	:	740-266-7673

Provider Business Practice Location Address
First Line	:	2315 SUNSET BLVD
Second Line	:	SUITE D
City	:	STEUBENVILLE
State	:	OH
Zip	:	43952-2496
Country	:	US
Telephone Number	:	740-266-7674
Fax Number	:	740-266-7673

Authorized Official
Title or Position	:	OWNER
Name	:	SHARON L KINEMOND
Credential	:
Telephone Number	:	740-266-4908

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	06/30/2010

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