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NPI Profile for BLACK ROCK ADVANCED MEDICAL IMAGING in GILLETTE, WY.
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diagnostic Radiology |
2085R0202X | 30 | Physician/Diagnostic Radiology | |
Physiological Laboratory, (Independent Physiological Lab) |
293D00000X | 47 | Independent Diagnostic Testing Facility (IDTF) |
| NPI # | 1649556838 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/01/2011 | |
| Last updated | 08/08/2024 - More than a year ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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BLACK ROCK ADVANCED MEDICAL IMAGING
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BLACK ROCK ADVANCED MEDICAL IMAGING