Provider Demographics
NPI:1447203849
Name:MIDWEST ULTRASOUND, INC.
Entity Type:Organization
Organization Name:MIDWEST ULTRASOUND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCHWEBLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-936-0444
Mailing Address - Street 1:8250 KENWOOD CROSSING WAY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3668
Mailing Address - Country:US
Mailing Address - Phone:513-936-0444
Mailing Address - Fax:
Practice Address - Street 1:8250 KENWOOD CROSSING WAY
Practice Address - Street 2:SUITE 225
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3668
Practice Address - Country:US
Practice Address - Phone:513-936-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH620346246XS1301X, 2471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY86032547Medicaid
OH000000009866OtherANTHEM OHIO FACETS
OH1620106OtherUNITED HEALTHCARE
IN200107420Medicaid
OH0770938Medicaid
KY86032547Medicaid
690006831Medicare PIN
OHID00121Medicare PIN