is a Pediatric Radiology in , . practices all healthcare services and medical treatments related to Pediatric Radiology. The NPI Number for is 1982715546. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1982715546 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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Provider's Primary Taxonomy Detail
| Speciality | Pediatric Radiology |
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| Taxonomy | 2085P0229X |
| Licence No | 23528 |
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Definition: A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the ca |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 246190 | NC | MAMSI | |
| P00604276 | NC | MEDICARE RAILROAD | |
| 560941927 | NC | UNITED HEALTHCARE | |
| 560941927 | NC | CIGNA | |
| 33653 | NC | BCBS | |
| 8933653 | NC | -- | |
| 300070220 | NC | RAILROAD MEDICARE | |
| 560941927 | NC | MEDCOST |
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