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General NPI Number Information
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NPI Number | 1487633780
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Entity Type | Organization
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Legal Business Name | SHELBY RADIOLOGICAL ASSOCIATES, PA
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 222 N LAFAYETTE ST SUITE 01
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City | SHELBY
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State | NC
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Zip | 28150-4444
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Country | US
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Telephone | 704-482-3880
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Fax | 704-487-0294
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Provider Business Mailing Address
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Address Line | 222 N LAFAYETTE ST SUITE 01
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City | SHELBY
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State | NC
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Zip | 28150-4444
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Country | US
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Telephone | 704-482-3880
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Fax | 704-487-0294
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Authorized Official
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Title or Position | CORPORATE SECRETARY
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Name | DR. MICHAEL DOUGLAS WEHMUELLER
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Credential | MD
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Telephone | 704-482-3880
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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 | 39419
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License Number State | NC
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