MEDICARE: SCIENTIFIC MEDICAL IMAGING, INC.

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	35-03-4176 K	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	:	1912900341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCIENTIFIC MEDICAL IMAGING, INC.

Provider Business Mailing Address
First Line	:	540 PARMALEE AVE
Second Line	:	SUITE 100
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44510-1605
Country	:	US
Telephone Number	:	330-746-1231
Fax Number	:	330-746-3827

Provider Business Practice Location Address
First Line	:	540 PARMALEE AVE
Second Line	:	SUITE 100
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44510
Country	:	US
Telephone Number	:	330-746-1231
Fax Number	:	330-746-3827

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHANDER M KOHLI
Credential	:	M.D.
Telephone Number	:	330-746-1231

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	08/22/2020

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