NPIViewer - Provider NPI 1588869929

NPI:	1588869929
Name:	FSH RADIOLOGY INC
Entity type:	Organization
Organization Name:	FSH RADIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:	OWNER
Authorized Official - Prefix:	DR
Authorized Official - First Name:	FRANK
Authorized Official - Middle Name:	E
Authorized Official - Last Name:	SEIDELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:	DO
Authorized Official - Phone:	216-255-5700
Mailing Address - Street 1:	3700 PARK EAST DR
Mailing Address - Street 2:	SUITE #300
Mailing Address - City:	BEACHWOOD
Mailing Address - State:	OH
Mailing Address - Zip Code:	44122-4305
Mailing Address - Country:	US
Mailing Address - Phone:	855-236-2649
Mailing Address - Fax:	877-631-3043
Practice Address - Street 1:	3700 PARK EAST DR
Practice Address - Street 2:	SUITE #300
Practice Address - City:	BEACHWOOD
Practice Address - State:	OH
Practice Address - Zip Code:	44122-4305
Practice Address - Country:	US
Practice Address - Phone:	855-236-2649
Practice Address - Fax:	877-631-3043
EIN:	<UNAVAIL>
Is Organization Subpart?:	No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:	2007-06-16
Last Update Date:	2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:

Primary?	Code	Type	Classification	Specialization	Group
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology	Group - Single Specialty

State	Identifier ID	ID Type	Issuer
MD	413791 00	Medicaid
OH	2763997	Medicaid
NC	5911930	Medicaid
OR	DP9327	Other	RXR GRP PTAN
CO	28007042	Medicaid
LA	1370584	Medicaid
NC	5911513	Medicaid
FL	000946000	Medicaid
KY	7100069090	Medicaid
ID	807660703	Medicaid
HI	DQ1028	Other	RXR MCR PTAN
FL	AF145B	Medicare PIN
CO	COB4783	Medicare PIN
MI	OP53320	Medicare PIN
MD	143775ZCL9	Medicare PIN
NJ	119753	Medicare PIN
OR	DP9327	Other	RXR GRP PTAN
MD	413791 00	Medicaid
LA	5DD19	Medicare PIN
ID	1370107	Medicare PIN
RI	000331002	Medicare PIN
UT	000065281	Medicare PIN
MA	0003310	Medicare PIN
KY	7100069090	Medicaid
OH	9369621	Medicare PIN
FL	AF145C	Medicare PIN
AZ	119873	Medicare PIN
NC	5911513	Medicaid
FL	000946000	Medicaid
HI	BD672A	Medicare PIN
DC	138683	Medicare PIN
KY	00501	Medicare PIN
CO	28007042	Medicaid
MS	512G700419	Medicare PIN
MO	MA1350	Medicare PIN
MI	MI1840	Medicare PIN
OK	OKB5484	Medicare PIN
PA	129908	Medicare PIN
TX	00Y399	Medicare PIN
NC	5911930	Medicaid
ME	331001	Medicare PIN
IL	215417	Medicare PIN
NV	BD861	Medicare PIN
LA	1370584	Medicaid
OH	2763997	Medicaid
KY	7100069090	Medicaid
RI	000331002	Medicare PIN
MS	512G700419	Medicare PIN