Organization
MEDICAL DIAGNOSTIC IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA CARLSEN (DIRECTOR OF BUSINESS DEVELOPMENT)
(414) 282-4100
Entity
Organization
Contact information
Practice address
6150 W LAYTON AVE, GREENFIELD, WI 53220-4608
(414) 282-4100
(414) 282-4105
Mailing address
6150 WEST LAYTON AVE, GREENFIELD, WI 53220
(414) 282-4100
(414) 282-4108
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32896000
—
WI
Enumeration date
08/24/2006
Last updated
02/05/2021
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