Organization
KENNEWICK RADIOLOGY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDIP A PATIDAR MD (PROVIDER OWNER)
(559) 455-4009
Entity
Organization
Contact information
Practice address
900 S AUBURN ST, KENNEWICK, WA 99336-5621
(559) 455-4009
(509) 586-5178
Mailing address
PO BOX 4030, PASCO, WA 99302-4030
(509) 392-5037
(559) 455-4004
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006814
—
OR
05
—
7138209
—
WA
Enumeration date
05/22/2007
Last updated
08/29/2019
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