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General NPI Number Information
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NPI Number | 1912504556
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Entity Type | Organization
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Legal Business Name | SENTARA ADVANCED IMAGING SOLUTIONS, LLC
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 5911 KINGSTOWNE VILLAGE PKWY STE 160
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City | ALEXANDRIA
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State | VA
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Zip | 22315-4644
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Country | US
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Telephone | 757-252-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 5911 KINGSTOWNE VILLAGE PKWY STE 160
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City | ALEXANDRIA
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State | VA
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Zip | 22315-4644
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Country | US
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Telephone | 757-252-2900
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DORIS PRINCE
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Credential |
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Telephone | 757-252-2760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471B0102X
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Taxonomy Name | Bone Densitometry Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2471M2300X
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Taxonomy Name | Mammography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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