Healthcare Provider Details

I. General information

NPI: 1215990171
Provider Name (Legal Business Name): EASTERN RADIOLOGISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 W ARLINGTON BLVD SUITE 210
GREENVILLE NC
27834-5758
US

IV. Provider business mailing address

PO BOX 30750
GREENVILLE NC
27833-0750
US

V. Phone/Fax

Practice location:
  • Phone: 252-752-5000
  • Fax: 252-752-0166
Mailing address:
  • Phone: 252-752-5000
  • Fax: 252-752-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIAN SCOTT KUSZYK
Title or Position: PRESIDENT
Credential: MD
Phone: 252-752-5000