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General NPI Number Information
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NPI Number | 1730144288
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Entity Type | Organization
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Legal Business Name | POSITRON EMISSION TOMOGRAPHY INSTITUTE OF HAMPTON ROADS
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 5357 HENNEMAN DR
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City | NORFOLK
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State | VA
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Zip | 23513-2401
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Country | US
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Telephone | 757-855-9700
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Fax | 757-855-9755
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Provider Business Mailing Address
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Address Line | 5357 HENNEMAN DR
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City | NORFOLK
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State | VA
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Zip | 23513-2401
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Country | US
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Telephone | 757-855-9700
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Fax | 757-855-9755
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Authorized Official
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Title or Position | CEO
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Name | MR. RALEIGH HAMILTON
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Credential |
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Telephone | 757-366-3100
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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 |
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License Number State |
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