Organization
INSTITUTE OF DIAGNOSTIC IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J HOFER SR. (PRESIDENT)
(701) 297-0305
Entity
Organization
Contact information
Practice address
11819 MIRACLE HILLS DR, SUITE 101, OMAHA, NE 68154-4428
(402) 898-3630
(402) 898-3635
Mailing address
2829 UNIVERSITY DR S, FARGO, ND 58103-6050
(701) 297-0305
(701) 235-4847
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04128
BCBS
NE
01
—
1015837
GREAT WEST
NE
Enumeration date
08/31/2006
Last updated
08/22/2020
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