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General NPI Number Information
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NPI Number | 1114012671
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC IMAGING ASSOCIATES
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 6108 GOV. G.C. PEERY HWY
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City | RICHLANDS
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State | VA
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Zip | 24641
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Country | US
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Telephone | 276-325-0461
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Fax | 276-325-0469
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Provider Business Mailing Address
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Address Line | 1745 VALLEY VIEW DRIVE
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City | BIG STONE GAP
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State | VA
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Zip | 24219
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Country | US
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Telephone | 276-325-0461
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Fax | 276-325-0469
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Authorized Official
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Title or Position | OWNER
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Name | M R RAMAKRISHNAN
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Credential | M.D.
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Telephone | 276-325-0461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101030628
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License Number State | VA
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