MEDICARE: NORTH METROPOLITAN RADIOLOGY ASSOCIATES, LLP

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
2	CA0820	OTHER	GA	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1437137031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH METROPOLITAN RADIOLOGY ASSOCIATES, LLP

Provider Business Mailing Address
First Line	:	PO BOX 1746
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-1746
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 MEDICAL CENTER BLVD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-7694
Country	:	US
Telephone Number	:	877-383-4442
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JON L SIEGEL
Credential	:
Telephone Number	:	678-312-2400

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	07/08/2022

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