MEDICARE: CHATHAM RADIOLOGISTS, PA

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
1	CA1131	OTHER	GA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285663443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHATHAM RADIOLOGISTS, PA

Provider Business Mailing Address
First Line	:	5354 REYNOLDS ST.
Second Line	:	STE. 102
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6008
Country	:	US
Telephone Number	:	912-355-2116
Fax Number	:	912-355-3653

Provider Business Practice Location Address
First Line	:	5354 REYNOLDS ST.
Second Line	:	STE. 102
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6008
Country	:	US
Telephone Number	:	912-355-2116
Fax Number	:	912-355-3653

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CINDY EDENFIELD
Credential	:	ADMINISTRATOR
Telephone Number	:	912-355-2116

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	12/05/2012

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Directions to “CHATHAM RADIOLOGISTS, PA ” Practice Location

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