Organization
RADIOLOGIC MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A. WIESE M.D. (MEDICAL DOCTOR)
(319) 545-7310
Entity
Organization
Contact information
Practice address
2769 HEARTLAND DR STE 105, CORALVILLE, IA 52241-2732
(319) 545-7310
(319) 545-7314
Mailing address
2771 OAKDALE BLVD STE 3, CORALVILLE, IA 52241-9747
(319) 545-7310
(319) 626-7314
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0025411
—
IA
01
—
02541
BLUE CROSS BLUE SHIELD
IA
Enumeration date
05/17/2006
Last updated
09/15/2023
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