1346631843 NPI number — MIDWEST IMAGING CENTER II, LLC

Table of content: DR. DANIEL JAMES MARING D.O. (NPI 1548780398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346631843 NPI number — MIDWEST IMAGING CENTER II, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST IMAGING CENTER II, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346631843
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 MAPLE VALLEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63640-1976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-760-1674
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 SOUTHTOWNE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POTOSI
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63664-5729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-436-6736
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BOOTS
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
MM
Authorized Official Telephone Number:
573-315-9109

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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