Organization
NORTHWOODS IMAGING ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S TO MD (PRESIDENT)
(906) 776-5565
Entity
Organization
Contact information
Practice address
1721 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801
(906) 779-9870
(906) 779-5888
Mailing address
PO BOX 668, IRON MOUNTAIN, MI 49801
(906) 779-9870
(906) 779-5888
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212 6010
WISCONSIN MEDICAID
WI
Enumeration date
01/22/2007
Last updated
08/22/2020
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