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Organization

SUMMIT VIRTUAL RADIOLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BRENDA ELAINE RAKESTRAW (PRACTICE MANAGER)
(770) 607-7339
Entity
Organization

Contact information

Practice address
10 BOWEN CT, CARTERSVILLE, GA 30120-2494
(770) 607-7339
(770) 607-0789
Mailing address
PO BOX 200096, CARTERSVILLE, GA 30120-9002
(770) 607-7339
(770) 607-0789

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
052547
GA
2085N0700X
Neuroradiology Physician
053685
GA
2085R0202X
Diagnostic Radiology Physician
031215
GA
2085R0202X
Diagnostic Radiology Physician
Primary
032167
GA
2085R0202X
Diagnostic Radiology Physician
049389
GA
2085R0202X
Diagnostic Radiology Physician
049409
GA
2085R0202X
Diagnostic Radiology Physician
052264
GA
2085R0202X
Diagnostic Radiology Physician
052547
GA
2085R0202X
Diagnostic Radiology Physician
054802
GA
2085R0202X
Diagnostic Radiology Physician
056198
GA
2085R0202X
Diagnostic Radiology Physician
057533
GA
2085R0202X
Diagnostic Radiology Physician
057821
GA
2085R0204X
Vascular & Interventional Radiology Physician
054657
GA
2085R0204X
Vascular & Interventional Radiology Physician
057821
GA

Other

Enumeration date
06/16/2010
Last updated
06/16/2010
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