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Organization

MODERN TELERADIOLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUNIL KINI MD (RADIOLOGIST)
(770) 779-2168
Entity
Organization

Contact information

Practice address
3959 WHITE HORSE LN SE, SMYRNA, GA 30080-6408
(843) 259-1938
Mailing address
3959 WHITE HORSE LN SE, SMYRNA, GA 30080-6408
(843) 259-1938

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
058050
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
449977167M
GA
Enumeration date
02/26/2015
Last updated
04/22/2019
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