Provider Demographics
NPI:1508979089
Name:ECG SCANNING & MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:ECG SCANNING & MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NASUTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-346-5837
Mailing Address - Street 1:3055 KETTERLING BLVD
Mailing Address - Street 2:SUITE 219
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1900
Mailing Address - Country:US
Mailing Address - Phone:800-346-5837
Mailing Address - Fax:937-395-4415
Practice Address - Street 1:18223 E TEN MILE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-5281
Practice Address - Country:US
Practice Address - Phone:586-948-3803
Practice Address - Fax:586-948-3804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0787141261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8462355OtherAETNA US HEALTHCARE
MI1002973OtherHEALTH ADVANTAGE
2338764OtherAETNA US HEALTHCARE
MI85572AOtherHAP
OF3159OtherBCBS OF MICHIGAN
060F373720OtherBCBS OF MICHIGAN
OH134910001OtherCARESOURCE
KY60E9OtherANTHEM BCBS
MIRAOH0013OtherMCARE
470000255OtherMEDICARE RR
MIP81358OtherBLUE CARE NETWORK HMO
200014360AOtherINDIANA HEALTH NETWORK
4631482OtherCARE CHOICES
200014360AOtherINDIANA HEALTH NETWORK
MI8462355OtherAETNA US HEALTHCARE