Organization
NORTHWEST DIAGNOSTIC IMAGING, INC
Active
Other names
Open MRI & Imaging of Douglasville, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization
Contact information
Practice address
6095 PROFESSIONAL PKWY, SUITE 101B, DOUGLASVILLE, GA 30134-5607
(770) 947-8100
(770) 947-3404
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
—
226870812
US DEPARTMENT OF LABOR
GA
01
—
CA0798
RAILROAD MEDICARE
GA
01
—
CH7800
RAILROAD MEDICARE
GA
01
—
DA0357
RAILROAD MEDICARE
GA
Enumeration date
11/09/2005
Last updated
05/20/2008
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