Provider Demographics
NPI:1942201876
Name:RADIOLOGY ASSOCIATES OF BEAVER DAM LTD
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF BEAVER DAM LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ARMATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-887-1153
Mailing Address - Street 1:116 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-2437
Mailing Address - Country:US
Mailing Address - Phone:920-887-1153
Mailing Address - Fax:920-887-1044
Practice Address - Street 1:116 MONROE ST
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-2437
Practice Address - Country:US
Practice Address - Phone:920-887-1153
Practice Address - Fax:920-887-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty