Organization
MOBILE DIAGNOSTIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN J GRAY III RDMS (CEO/PRESIDENT)
(302) 239-7700
Entity
Organization
Contact information
Practice address
25 S OLD BALTIMORE PIKE, STE 104, NEWARK, DE 19702-1540
(302) 292-2700
(302) 292-2702
Mailing address
25 S OLD BALTIMORE PIKE, STE 104, NEWARK, DE 19702-1540
(302) 292-2700
(302) 292-2702
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1990032819
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000330426
HIGHMARK INC
PA
01
—
0005018072
AETNA
TX
01
—
021642
HIGHMARK MEDICARE
PA
05
—
405833000
—
MD
01
—
574438109
UNITED AMERICAN INSURANCE
TX
05
—
X000596201
—
AZ
Enumeration date
02/09/2007
Last updated
09/02/2013
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