Individual
DONALD KOLMAN IMWALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 MACK RD, FAIRFIELD, OH 45014-5335
(513) 965-8041
(513) 965-8091
Mailing address
1331 N ELM ST, SUITE 200, GREENSBORO, NC 27401-6302
(336) 274-9617
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35084579
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008517420A
—
IN
05
—
2738041
—
OH
Enumeration date
06/05/2006
Last updated
01/10/2024
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