Organization
MARIETTA IMAGING INC
Active
Organization
MARIETTA IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C GROSEL MD (PRESIDENT)
(740) 374-1410
Entity
Organization
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 374-1410
(740) 374-1691
Mailing address
PO BOX 182255, COLUMBUS, OH 43218-2255
(614) 430-5729
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006955000
—
WV
05
—
0778583
—
OH
01
—
CB3073
MEDICARE RAILROAD
—
Enumeration date
05/27/2006
Last updated
11/15/2007
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