Healthcare Provider Details

I. General information

NPI: 1912292988
Provider Name (Legal Business Name): ST. THOMAS RADIOLOGY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUNNY ISLE SHOPP CTR SPC B-2
ST CROIX VI
00820-4493
US

IV. Provider business mailing address

PO BOX 11839
ST THOMAS VI
00801-4839
US

V. Phone/Fax

Practice location:
  • Phone: 340-778-5840
  • Fax: 340-778-5844
Mailing address:
  • Phone: 340-774-0265
  • Fax: 340-776-0228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number745
License Number StateVI

VIII. Authorized Official

Name: DR. GEORGE I. ROSENBERG
Title or Position: MEMBER
Credential: M.D.
Phone: 340-774-0265