Dale Roger Shampo in Iron Mountain - Diagnostic Radiology
Dale Roger Shampo - NPI 1124107917
Dale Roger Shampo is a Diagnostic Radiology in Iron Mountain, Michigan. Dale Roger Shampo practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for Dale Roger Shampo is 1124107917. The last update date is 2007-07-08.
Dale Roger Shampo's current location address is 1721 S Stephenson Ave, Iron Mountain, Michigan. You can contact this provider via phone number 9067741313. The mailing address for Dale Roger Shampo is 1721 S Stephenson Ave, Iron Mountain, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dale Roger Shampo |
|---|---|
| Address | 1721 S Stephenson Ave, Iron Mountain, Michigan |
| Phone Number | 9067741313 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1124107917 |
|---|---|
| Provider Enumeration Date | 2006-11-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1721 S Stephenson Ave |
|---|---|
| City | Iron Mountain |
| State | Michigan (MI) |
| Post Code | 498013637 |
| Phone Number | 9067741313 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
| Licence No | 4301029974 |
|
Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 30436700 | WI | -- | |
| 1386409 | MI | MOLINA | |
| 1386409 | MI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Dale Roger Shampo by the Centers for Medicare & Medicaid Services?
The Dale Roger Shampo has been issued the NPI (National Provider Identifier) 1124107917 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Dale Roger Shampo's facilities are situated?
The facilities of Dale Roger Shampo are physically located at the following address: 1721 S Stephenson Ave, Iron Mountain, MI, 498013637.
What is the Dale Roger Shampo's specialty and taxonomy code?
The Dale Roger Shampo's specialty is Diagnostic Radiology, and the corresponding taxonomy code is 2085R0202X.
On what date was the 1124107917 assigned to Dale Roger Shampo?
The Dale Roger Shampo was issued its 1124107917 on 2006-11-03, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Dale Roger Shampo, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Dale Roger Shampo, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-08.
NPI Number: 1699778829
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