| NPI | 1285208009 |
|---|---|
| Doing Business As | THE PROVIDENCE DIAGNOSTIC IMAGING CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL DUNWELL Coord Credentialing 202-854-4069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) |
| 261QR0200X Clinic/Center, Radiology | |
| 261QR0206X Clinic/Center, Radiology, Mammography | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2022-05-06 |