Healthcare Provider Details

I. General information

NPI: 1639273709
Provider Name (Legal Business Name): MOBILE MEDICAL IMAGING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 11/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CONGRESS STREET SUITE 3
PORTLAND ME
04102-2141
US

IV. Provider business mailing address

1601 CONGRESS STREET SUITE 3
PORTLAND ME
04102-2141
US

V. Phone/Fax

Practice location:
  • Phone: 207-774-0885
  • Fax: 207-774-7694
Mailing address:
  • Phone: 207-774-0885
  • Fax: 207-774-7694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN M NOBLE
Title or Position: VICE PRESIDENT/TREASURER
Credential: RDMS
Phone: 207-774-0720