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General NPI Number Information
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NPI Number | 1285310532
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Entity Type | Organization
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Legal Business Name | IMAGING SPECIALISTS OF NC, PLLC
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 3200 NORTHLINE AVE STE 160
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City | GREENSBORO
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State | NC
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Zip | 27408-7613
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Country | US
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Telephone | 336-545-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 750 OLD HICKORY BLVD STE 1-260
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City | BRENTWOOD
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State | TN
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Zip | 37027-4528
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Country | US
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Telephone | 615-376-7502
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK AWH
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Credential | MD
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Telephone | 615-376-7502
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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 |
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License Number State |
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