Organization
NORTHSHORE IMAGING ASSOC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. E MICHAEL DONNER III MD (MANAGING PARTNER)
(985) 542-8190
Entity
Organization
Contact information
Practice address
15837 PAUL VEGA MD DR, STE 200, HAMMOND, LA 70403-1462
(985) 542-8190
(985) 543-0031
Mailing address
PO BOX 2277, HAMMOND, LA 70404-2277
(985) 542-8190
(985) 543-0031
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1795372
—
LA
05
—
9013833
—
MS
Enumeration date
11/08/2005
Last updated
08/22/2020
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