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General NPI Number Information
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NPI Number | 1295790657
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Entity Type | Organization
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Legal Business Name | MECKLENBURG RADIOLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 3623 LATROBE DR SUITE 216
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City | CHARLOTTE
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State | NC
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Zip | 28211-1187
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Country | US
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Telephone | 704-332-1291
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Fax | 704-332-5206
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Provider Business Mailing Address
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Address Line | PO BOX 221249
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City | CHARLOTTE
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State | NC
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Zip | 28222-1249
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Country | US
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Telephone | 704-332-1291
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Fax | 704-332-5206
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | MRS. CATHERINE B FRENCH
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Credential |
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Telephone | 980-208-1704
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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 | NC
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