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General NPI Number Information
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NPI Number | 1396344859
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Entity Type | Individual
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Provider Name | RAYMOND ROSS R.T.(R)(CT)(MR)(ARRT
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Gender | Male
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Dates
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Enumeration Date | 10/25/2020
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Last Update Date | 10/25/2020
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Provider Practice Location Address
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Address Line | 1325 OLEANDER AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23325-3745
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Country | US
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Telephone | 757-401-5851
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 OLEANDER AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23325-3745
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Country | US
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Telephone | 757-401-5851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 510394
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number | 510394
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number | 510394
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | 510394
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License Number State | VA
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