Healthcare Provider Details
I. General information
NPI: 1679407381
Provider Name (Legal Business Name): HERITAGE IMAGING GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 ABERNATHY RD
SANDY SPRINGS GA
30328-5620
US
IV. Provider business mailing address
1100 ABERNATHY RD
SANDY SPRINGS GA
30328-5620
US
V. Phone/Fax
- Phone: 617-586-2299
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
SHINKLE
Title or Position: PRESIDENT
Credential: D.O.
Phone: 215-990-6708