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General NPI Number Information
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NPI Number | 1225117187
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Entity Type | Organization
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Legal Business Name | MEDSCAN IMAGING, INC.
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4037 TAYLOR RD SUITE D
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5535
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Country | US
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Telephone | 757-923-1111
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Fax | 757-923-1111
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Provider Business Mailing Address
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Address Line | 4037 TAYLOR RD SUITE D
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5535
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Country | US
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Telephone | 757-923-1111
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Fax | 757-923-1111
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Authorized Official
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Title or Position | REGISTER DIAGNOSTIC MEDICAL SONOGRA
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Name | PROF. BRENDA L. LONG
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Credential | RTR.RDMS
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Telephone | 757-923-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 00917
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License Number State | VA
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