Organization
DURHAM DIAGNOSTIC IMAGING LLC
Active
Other names
Triangle Medical Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY K. GARDNER (SVP FINANCE AND REVENUE CYCLE)
(336) 718-2078
Entity
Organization
Contact information
Practice address
5107 S PARK DR, DURHAM, NC 27713-8400
(919) 544-7199
(919) 544-2621
Mailing address
PO BOX 933393, ATLANTA, GA 31193-0001
(336) 659-1211
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020FV
BCBS
NC
01
—
205314601
DOL
NC
01
—
2670289
UHC
—
05
—
5902435
—
NC
01
—
7730393
AETNA
—
01
—
P00014222
MEDICARE RR
—
Enumeration date
05/04/2006
Last updated
03/20/2024
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