Individual
WAYDE HITOSHI NAGAMINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3249 OAK PARK AVE, METROPOLITAN ADVANCED RADIOLOGICAL SERVICES, BERWYN, IL 60402-3429
(708) 783-2696
(708) 783-3164
Mailing address
3249 OAK PARK AVE, METROPOLITAN ADVANCED RADIOLOGICAL SERVICES, BERWYN, IL 60402-3429
(708) 783-2696
(708) 783-3164
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
036-116127
IL
2085R0202X
Diagnostic Radiology Physician
093376
OH
2085R0202X
Diagnostic Radiology Physician
13005
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116127
—
IL
Enumeration date
04/16/2008
Last updated
06/10/2009
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