Organization
SIRA IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK BISESI M.D. (PRESIDENT)
(812) 332-8242
Entity
Organization
Contact information
Practice address
500 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 332-8242
(812) 333-7684
Mailing address
PO BOX 4366, BLOOMINGTON, IN 47402-4366
(812) 332-8242
(812) 333-7684
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200152570
—
IN
Enumeration date
04/18/2006
Last updated
11/30/2010
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