Organization
TWINCITY MEDICAL MOBILE DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD O. CORNWALL PA-C (PRESIDENT)
(336) 816-6800
Entity
Organization
Contact information
Practice address
163 STRATFORD CT, WINSTON SALEM, NC 27103
(336) 816-6800
(888) 507-6778
Mailing address
163 STRATFORD CT, WINSTON SALEM, NC 27103-1836
(336) 816-6800
(888) 507-6778
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
261QR0208X
Mobile Radiology Clinic/Center
21159
NC
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
21159
NC
Other
Enumeration date
06/05/2015
Last updated
09/12/2018
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