Organization
REIDSVILLE IMAGING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND EVELAND (MEMBER)
(336) 202-5593
Entity
Organization
Contact information
Practice address
2509 RICHARDSON DR, SUITE A, REIDSVILLE, NC 27320-5901
(336) 349-5899
(336) 349-5995
Mailing address
PO BOX 16983, CHAPEL HILL, NC 27516-6983
(919) 967-6646
(919) 967-6647
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017YH
BLUE CROSS/BLUE SHIELD
NC
05
—
5904292
—
NC
Enumeration date
06/10/2006
Last updated
01/16/2009
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