Organization
CAHABA VALLEY IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES MICHAEL MEAD M.D. (PRESIDENT)
(205) 823-0882
Entity
Organization
Contact information
Practice address
201 RACQUET CLUB LANE, PELHAM, AL 35124
(205) 418-1212
(205) 418-1214
Mailing address
502 MONTGOMERY HWY, SUITE 101, VESTAVIA HILLS, AL 35216-1862
(205) 418-1212
(205) 418-1214
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
17189
AL
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
17189
AL
2085N0904X
Nuclear Radiology Physician
17189
AL
2085R0202X
Diagnostic Radiology Physician
Primary
17189
AL
2085R0204X
Vascular & Interventional Radiology Physician
17189
AL
2085U0001X
Diagnostic Ultrasound Physician
17189
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043215114
PROVIDER NPI - SANDRA BALK MARTIN, MD
AL
01
—
1104821297
PROVIDER NPI - PHILLIP ARTHUR TRIANTOS, MD
AL
01
—
1205833761
PROVIDER NPI - CHARLES MICHAEL MEAD, MD
AL
Enumeration date
01/28/2010
Last updated
01/28/2010
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