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NPI Code Detail

MEDICARE: BIO-MOLECULAR IMAGING & THERAPY, LLC.

MEDICARE: BIO-MOLECULAR IMAGING & THERAPY, 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
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/CenterGA 1545-1GA
2261QR0200XRadiology Clinic/CenterGA-1545-1GA

Other Identifiers

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

General Provider Information

NPI Number : 1841469871
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIO-MOLECULAR IMAGING & THERAPY, LLC.
Provider Business Mailing Address
First Line : 3305 BOBBY BROWN PKWY
Second Line :
City : EAST POINT
State : GA
Zip : 30344-5012
Country : US
Telephone Number : 678-471-6073
Fax Number : 770-964-1105
Provider Business Practice Location Address
First Line : 3305 BOBBY BROWN PKWY
Second Line :
City : EAST POINT
State : GA
Zip : 30344-5012
Country : US
Telephone Number : 678-471-6073
Fax Number : 770-964-1105
Authorized Official
Title or Position : PHYSICIAN
Name : DR. SHASHIKANT A DAYA
Credential : M.D.
Telephone Number : 404-806-8181
Provider Enumeration Date : 02/24/2008
Last Update Date : 10/31/2011

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Directions to “BIO-MOLECULAR IMAGING & THERAPY, LLC. ” Practice Location

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