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General NPI Number Information
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NPI Number | 1790739985
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Entity Type | Organization
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Legal Business Name | AMERIRAD INC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 99 J D ANDERSON DR
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City | MORGANTOWN
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State | WV
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Zip | 26505-4000
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Country | US
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Telephone | 304-598-2291
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Fax | 304-598-2293
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Provider Business Mailing Address
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Address Line | PO BOX 1645
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City | MORGANTOWN
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State | WV
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Zip | 26507-1645
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Country | US
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Telephone | 304-598-2291
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Fax | 304-598-2293
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS M. BURTON
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Credential | MD
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Telephone | 304-598-2291
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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 | NA
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License Number State | WV
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