Provider Demographics
NPI:1275824682
Name:NEUMED DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:NEUMED DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:NEUENDORFF
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, RPFT
Authorized Official - Phone:330-721-4747
Mailing Address - Street 1:9906 NORWALK RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44253-9502
Mailing Address - Country:US
Mailing Address - Phone:330-721-4747
Mailing Address - Fax:330-721-0726
Practice Address - Street 1:9906 NORWALK RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44253-9502
Practice Address - Country:US
Practice Address - Phone:330-721-4747
Practice Address - Fax:330-721-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRCP 1458293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory