Provider Demographics
NPI:1316105430
Name:MEDICAL IMAGING NETWORK
Entity type:Organization
Organization Name:MEDICAL IMAGING NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLEGGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-726-9006
Mailing Address - Street 1:819 MCKAY CT
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5713
Mailing Address - Country:US
Mailing Address - Phone:330-726-2071
Mailing Address - Fax:330-726-9007
Practice Address - Street 1:819 MCKAY CT
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5713
Practice Address - Country:US
Practice Address - Phone:330-726-2071
Practice Address - Fax:330-726-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350509312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000317482OtherANTHEM
OH000000317493OtherANTHEM
OH16-00686OtherUNITED HEALTHCARE
OH5104619OtherAETNA
OHCI4668OtherRAILROAD MEDICARE
OH000000317476OtherANTHEM
OH2251905Medicaid
OH2086273Medicaid
OH2358238Medicaid
OH000000317493OtherANTHEM
OH9299169Medicare PIN
OH9299167Medicare PIN
OH5104619OtherAETNA
OH9299161Medicare PIN
OH2251905Medicaid
OH9299164Medicare PIN