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NPI Code Detail

MEDICARE: CABARRUS DIAGNOSTIC IMAGING LLC

MEDICARE: CABARRUS DIAGNOSTIC IMAGING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianNC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1470001082OTHERMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2012ANOTHERNCBCBS NC
3166146500OTHERNCDOL
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376591545
Entity Type Code : Organization
Provider Name (Legal Business Name) : CABARRUS DIAGNOSTIC IMAGING LLC
Provider Business Mailing Address
First Line : PO BOX 603543
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-3543
Country : US
Telephone Number : 678-393-5600
Fax Number : 770-300-9018
Provider Business Practice Location Address
First Line : 13460 PLAZA ROAD EXT STE 150
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-8923
Country : US
Telephone Number : 704-262-9885
Fax Number :
Authorized Official
Title or Position : SVP FINANCE AND REVENUE CYCLE
Name : MR. GEOFFREY K. GARDNER
Credential :
Telephone Number : 336-718-2078
Provider Enumeration Date : 05/04/2006
Last Update Date : 03/20/2024

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Directions to “CABARRUS DIAGNOSTIC IMAGING LLC ” Practice Location

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