Organization
ADVANCED IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHODHAN L PATEL MD (MEDICAL DIRECTOR)
(219) 864-2900
Entity
Organization
Contact information
Practice address
7860 BURR ST, SCHERERVILLE, IN 46375
(219) 864-2900
(219) 864-2910
Mailing address
7860 BURR ST, SCHERERVILLE, IN 46375
(219) 864-2900
(219) 864-2910
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
1996061345
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200169610
—
IN
Enumeration date
05/24/2005
Last updated
02/24/2009
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