Organization
TIDEWATER DIAGNOSTIC IMAGING LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI SHAMAIENGAR MD (PRESIDENT)
(757) 984-7911
Entity
Organization
Contact information
Practice address
3000 COLISEUM DR, HAMPTON, VA 23666-5963
(757) 736-1621
(757) 512-5025
Mailing address
PO BOX 844723, BOSTON, MA 02284-4723
(866) 759-4524
(757) 512-5025
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
08/17/2006
Last updated
08/18/2021
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