Organization
DIAGNOSTIC MEDICAL IMAGING ENTERPRISES, LTD
Active
Other names
Diagnostic Medical, P. C.
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX B BODENSTAB MD (MEDICAL DIRECTOR)
(610) 261-4898
Entity
Organization
Contact information
Practice address
3330 PHEASANT DR, NORTHAMPTON, PA 18067-9614
(610) 261-4898
(610) 261-4899
Mailing address
3330 PHEASANT DR, NORTHAMPTON, PA 18067-9614
(610) 261-4898
(610) 261-4899
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
MD037186E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01383052
HIGHMARK BLUE SHIELD
PA
01
—
2086219000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
01/12/2006
Last updated
05/05/2008
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