Healthcare Provider Details

I. General information

NPI: 1346332392
Provider Name (Legal Business Name): MOBILE RADIOLOGY & IMAG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 POPLAR PL S
SEATTLE WA
98144-2827
US

IV. Provider business mailing address

PO BOX 959
MERCER ISLAND WA
98040-0959
US

V. Phone/Fax

Practice location:
  • Phone: 206-568-4440
  • Fax: 206-720-4403
Mailing address:
  • Phone: 206-568-4440
  • Fax: 206-720-4403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: NEIL F SCHNEIDER
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 206-568-4440