Organization
INSTITUTE OF DIAGNOSTIC IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J HOFER SR. (PRESIDENT)
(701) 297-0305
Entity
Organization
Contact information
Practice address
2829 SOUTH UNIVERSITY DRIVE, SUITE 102, FARGO, ND 58103-6029
(701) 234-0112
(701) 235-9660
Mailing address
3223 32ND AVENUE S, SUITE 201, FARGO, ND 58103-6278
(701) 297-0305
(701) 235-9660
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10342
—
ND
01
—
123669600
FEDERAL WORK COMP
—
01
—
1602915
MEDICA
—
01
—
2109663
FIRST HEALTH
—
01
—
25965
BCBS
ND
01
—
300087709
UNITED HEALTHCARE
—
01
—
34Q05IN
BCBS
MN
01
—
470000565
RAILROAD MEDICARE
—
05
—
627327100
—
MN
05
—
7290170
—
SD
01
—
933411015837
PREFERRED ONE
—
Enumeration date
08/31/2006
Last updated
08/07/2012
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