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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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