Organization
MSN IMAGING PROFESSIONALS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY A BLACKBURN M.D. (PRESIDENT)
(216) 688-8000
Entity
Organization
Contact information
Practice address
4330 W 150TH ST, SUITE 101, CLEVELAND, OH 44135-1362
(216) 688-8000
(216) 688-0075
Mailing address
4330 W 150TH ST, SUITE 101, CLEVELAND, OH 44135-1362
(216) 688-8000
(216) 688-0075
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35-053437
OH
2085R0204X
Vascular & Interventional Radiology Physician
Primary
34-053437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000169054
ANTHEM
OH
05
—
0629172
—
OH
01
—
92915
QUALCHOICE
OH
Enumeration date
09/28/2006
Last updated
09/11/2025
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