Basic Information
| Provider Information | |||||||||
| NPI: | 1790749984 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHILLON-ACOSTA | ||||||||
| FirstName: | RAMINDER | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 72384 | ||||||||
| Address2: | RADIOLOGY ASSOCIATES OF CANTON, INC. | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886861837 | ||||||||
| FaxNumber: | 3306865928 | ||||||||
| Practice Location | |||||||||
| Address1: | 777 BANNOCK ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802044507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036023192 | ||||||||
| FaxNumber: | 3036022719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 06/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 34008689 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085N0700X | 34008689 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | 34008689 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085U0001X | 34008689 | OH | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | 2085R0202X | DR.0068825 | CO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 2649209 | 05 | OH | MEDICAID | P00293814 | 01 | OH | RAILROAD MEDICARE | OTHER |