Organization
NORTHWEST DIAGNOSTIC IMAGING, INC
Active
Other names
Imaging Center of Central Georgia
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization
Contact information
Practice address
2706 WATSON BLVD, SUITE D, WARNER ROBINS, GA 31093-2997
(678) 953-6033
(478) 953-6047
Mailing address
PO BOX 932391, ATLANTA, GA 31193-2391
(678) 393-5600
(770) 300-9018
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G476217
MEDICARE IDTF
GA
01
—
226870803
US DEPARTMENT OF LABOR
GA
01
—
CA0798
RAILROAD MEDICAIRE
GA
01
—
CH7801
RAILROAD MEDICARE
GA
01
—
DA0357
RAILROAD MEDICARE
GA
Enumeration date
11/10/2005
Last updated
03/08/2010
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