| Donald Kolman Imwalle, MD | |
|
3000 Mack Rd, Fairfield, OH 45014-5335 | |
| (513) 965-8041 | |
| (513) 965-8091 |
| Full Name | Donald Kolman Imwalle |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 24 Years |
| Location | 3000 Mack Rd, Fairfield, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164461372 | NPI | - | NPPES |
| 2008517420A | Medicaid | IN | |
| 2738041 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 35084579 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cleveland Clinic Indian River Hospital | Vero beach, FL | Hospital |
| Cleveland Clinic Martin North Hospital | Stuart, FL | Hospital |
| Lawnwood Regional Medical Center & Heart Institute | Fort pierce, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cleveland Clinic Florida (a Nonprofit Corporation) | 7911807128 | 652 |
| Entity Name | Cleveland Clinic Florida (a Nonprofit Corporation) |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215989298 PECOS PAC ID: 7911807128 Enrollment ID: O20040113000394 |
| Mailing Address | Practice Location Address |
|---|---|
| Donald Kolman Imwalle, MD 1331 N Elm St, Suite 200, Greensboro, NC 27401-6302 Ph: (336) 274-9617 | Donald Kolman Imwalle, MD 3000 Mack Rd, Fairfield, OH 45014-5335 Ph: (513) 965-8041 |
Dr. Michael A Cross, MD Radiology Medicare: Medicare Enrolled Practice Location: 2960 Mack Rd Ste 105, Fairfield, OH 45014 Phone: 513-751-2273 Fax: 513-751-1840 | |
Bradford Harold Woodall, MD Radiology Medicare: Medicare Enrolled Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091 | |
Robert A Love Iii, MD Radiology Medicare: Medicare Enrolled Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091 | |
Jeffrey I Grass, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2960 Mack Rd Ste 105, Fairfield, OH 45014 Phone: 513-751-2273 | |
Susan Marie Cha, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091 | |
Timothy Joseph Phalen, MD Radiology Medicare: Medicare Enrolled Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091 |