MEDICARE: SCOTLAND IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	DF0201	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	017M9	OTHER	NC	BC BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225018682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTLAND IMAGING LLC

Provider Business Mailing Address
First Line	:	PO BOX 52
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28302-0052
Country	:	US
Telephone Number	:	866-494-8266
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 E LAUCHWOOD DR
Second Line	:
City	:	LAURINBURG
State	:	NC
Zip	:	28352-5502
Country	:	US
Telephone Number	:	910-610-1116
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SCOTT T MCGRAW
Credential	:
Telephone Number	:	866-494-8266

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	07/18/2007

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Directions to “SCOTLAND IMAGING LLC ” Practice Location

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