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General NPI Number Information
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NPI Number | 1215268446
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Entity Type | Organization
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Legal Business Name | CAHABA VALLEY IMAGING, LLC
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 201 RACQUET CLUB LANE
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City | PELHAM
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State | AL
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Zip | 35124
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Country | US
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Telephone | 205-418-1212
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Fax | 205-418-1214
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Provider Business Mailing Address
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Address Line | 502 MONTGOMERY HWY SUITE 101
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City | VESTAVIA HILLS
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State | AL
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Zip | 35216-1862
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Country | US
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Telephone | 205-418-1212
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Fax | 205-418-1214
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES MICHAEL MEAD
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Credential | M.D.
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Telephone | 205-823-0882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 17189
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | 17189
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 17189
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 17189
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 17189
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License Number State | AL
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 17189
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License Number State | AL
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