Healthcare Provider Details

I. General information

NPI: 1003069436
Provider Name (Legal Business Name): AMERICAN IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2897 N DRUID HILLS RD NE SUITE 304
ATLANTA GA
30329-3924
US

IV. Provider business mailing address

2897 N DRUID HILLS RD NE SUITE 304
ATLANTA GA
30329-3924
US

V. Phone/Fax

Practice location:
  • Phone: 404-388-6686
  • Fax: 561-989-3689
Mailing address:
  • Phone: 404-388-6686
  • Fax: 561-989-3680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number47BBBLM
License Number StateGA

VIII. Authorized Official

Name: MR. NATE HOLLANDER
Title or Position: PRESIDENT
Credential:
Phone: 404-388-6686