Individual
MICHAEL IM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2624 DAWSON RD, ALBANY, GA 31707-1609
(229) 888-1624
Mailing address
700 E MOREHEAD ST STE 300, CHARLOTTE, NC 28202-2742
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
109415
GA
2085R0202X
Diagnostic Radiology Physician
A119769
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A119769
STATE
CA
Enumeration date
05/09/2008
Last updated
12/12/2025
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