MEDICARE: EXCEL 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
1	2085R0202X	Diagnostic Radiology Physician		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538273990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEL IMAGING LLC

Provider Business Mailing Address
First Line	:	3155 MAPLEWOOD AVE
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-3903
Country	:	US
Telephone Number	:	336-794-4372
Fax Number	:	336-659-2379

Provider Business Practice Location Address
First Line	:	280 BROAD ST STE F
Second Line	:
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-2948
Country	:	US
Telephone Number	:	336-794-4372
Fax Number	:	336-659-2379

Authorized Official
Title or Position	:	CFO
Name	:	LINDA SKARZYNSKI
Credential	:
Telephone Number	:	336-794-4372

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	08/22/2020

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Directions to “EXCEL IMAGING LLC ” Practice Location

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