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General NPI Number Information
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NPI Number | 1114126489
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Entity Type | Organization
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Legal Business Name | EAST COAST IMAGING ASSOC PA
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 301 WIDGEON DR
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City | HAMPSTEAD
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State | NC
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Zip | 28443-2436
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Country | US
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Telephone | 910-270-2108
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Fax |
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Provider Business Mailing Address
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Address Line | 301 WIDGEON DR
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City | HAMPSTEAD
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State | NC
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Zip | 28443-2436
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Country | US
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Telephone | 910-270-2108
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH WILLIAM FISCHER
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Credential | M.D.
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Telephone | 910-270-2108
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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 | 32236
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License Number State | NC
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