Organization
IMAGE RADIOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA L REBAR (OFFICE MANAGER)
(724) 489-0263
Entity
Organization
Contact information
Practice address
4198 WASHINGTON RD, MC MURRAY, PA 15317-2560
(724) 942-5144
(724) 942-8141
Mailing address
90 CHAMBER PLZ, CHARLEROI, PA 15022-1620
(724) 489-0263
(724) 489-0267
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012584360009
—
PA
05
—
0012584360010
—
PA
05
—
0012584360011
—
PA
05
—
0012584360013
—
PA
05
—
0012584360014
—
PA
05
—
0012584360015
—
PA
05
—
0012584360018
—
PA
01
—
0508628
AETNA
PA
01
—
1009731
GATEWAY HEALTH PLAN
PA
01
—
1537247
UNITED MINE WORKERS
PA
01
—
19136
HEALTH AMERICA
PA
01
—
62457
UNISON
PA
01
—
710328
BLUECROSS/BLUESHIELD
PA
01
—
C10824
RAILROAD MEDICARE
PA
Enumeration date
01/04/2006
Last updated
01/28/2008
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