Organization
PROSCAN IMAGING OF INDIANAPOLIS, LLC
Active
Other names
ProScan Imaging of Fishers
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE D. O'BRIEN (COO)
51392813400
Entity
Organization
Contact information
Practice address
9780 LANTERN RD, SUITE 250, FISHERS, IN 46037-4092
(317) 579-7700
(317) 579-8800
Mailing address
9780 LANTERN RD, SUITE 250, FISHERS, IN 46037-4092
(317) 579-7700
(317) 579-8800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000477513
ANTHEM PIN
—
Enumeration date
12/11/2006
Last updated
01/28/2008
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