Organization
SUFFOLK RADIOLOGY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CANADA (COO)
(804) 262-6900
Entity
Organization
Contact information
Practice address
2800 GODWIN BLVD, SUFFOLK, VA 23434-8038
(757) 366-0101
(757) 366-8792
Mailing address
PO BOX 15539, SUFFOLK RADIOLOGY ASSOCIATES, RICHMOND, VA 23227-5539
(757) 366-0101
(757) 366-8792
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA1602
RAILROAD MEDICARE
VA
Enumeration date
05/16/2006
Last updated
10/01/2014
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