ADVANCED DIAGNOSTIC RADIOLOGY PC NPI 1922006519

NPI Information

NPI: 1922006519
Provider Name: ADVANCED DIAGNOSTIC RADIOLOGY PC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
1301 15TH AVE W
WILLISTON, ND
ZIP 58801
Phone: (701) 774-7401
Get Directions

ADVANCED DIAGNOSTIC RADIOLOGY PC is a diagnostic radiology radiology in Williston, ND. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. ADVANCED DIAGNOSTIC RADIOLOGY PC NPI is 1922006519. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1301 15TH AVE W
WILLISTON, ND
ZIP 58801-821
Phone: (701) 774-7401

The provider's authorized official is Glenn P Moradian .
The authorized official title is President and has the following contact phone number (208) 557-0999.

The enumeration date for this NPI number is 7/8/2005 and was last updated on 10/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	POC - 8L501	OTHER	IDAHO	BC NUMBER FOR POCATELLO
2	IF - 8L493	OTHER	IDAHO	BC NUMBER - IDAHO FALLS
3	000010149528	OTHER	IDAHO	BLUE SHIELD NUMBER
4	15040	MEDICAID	NORTH DAKOTA
5	807083700	MEDICAID	IDAHO
6	1378805	MEDICARE PIN	IDAHO
7	8M916	OTHER	UTAH	BC OF IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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