Healthcare Provider Details

I. General information

NPI: 1366752487
Provider Name (Legal Business Name): UNITED MOBILE IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2554 LEWISVILLE CLEMMONS RD SUITE 201 BOX 11
CLEMMONS NC
27012-8110
US

IV. Provider business mailing address

2554 LEWISVILLE CLEMMONS RD SUITE 201 BOX 11
CLEMMONS NC
27012-8110
US

V. Phone/Fax

Practice location:
  • Phone: 800-983-9840
  • Fax: 800-983-9841
Mailing address:
  • Phone: 800-983-9840
  • Fax: 800-983-9841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3409809
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MR. PAUL DARRYL SMITH JR.
Title or Position: PRESIDENT/CEO
Credential:
Phone: 336-403-3152