Organization
MID AMERICAN IMAGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS A. POAN (SVP CORPORATE FINANCE)
(949) 242-5321
Entity
Organization
Contact information
Practice address
659 BOULEVARD ST, DOVER, OH 44622-2026
(330) 343-3311
Mailing address
100 BAYVIEW CIRCLE, SUITE 400, NEWPORT BEACH, CA 92660-2984
(800) 544-3215
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
02220180040
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000166606
ANTHEM BCBS OF OHIO
OH
05
—
2368727
—
OH
01
—
23753
MEDFOCUS RADIOLOGY NETWOR
OH
01
—
366270200
ACS/US DEPT OF LABOR
OH
05
—
47710-0001
—
OH
05
—
731337
—
OH
Enumeration date
06/07/2006
Last updated
12/08/2008
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