Organization
PROSCAN IMAGING OF INDIANAPOLIS, LLC
Active
Other names
ProScan Imaging of Avon
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D. O'BRIEN (COO)
(513) 281-3400
Entity
Organization
Contact information
Practice address
5250 E US HIGHWAY 36, PRESTWICK POINTE SUITE 220, AVON, IN 46123-9199
(317) 745-3200
(317) 745-4214
Mailing address
5250 E US HIGHWAY 36, PRESTWICK POINTE SUITE 220, AVON, IN 46123-9199
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000477513
ANTHEM PIN
—
Enumeration date
12/11/2006
Last updated
01/25/2008
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