Organization
MAGNETIC RESONANCE IMAGING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD NICHOLAS MD (MEDICAL DIRECTOR)
(207) 945-4680
Entity
Organization
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 945-4680
(207) 945-4689
Mailing address
PO BOX 1188, BANGOR, ME 04402-1188
(207) 945-4680
(207) 945-4689
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123480000
—
ME
01
—
M0184
ANTHEM
ME
Enumeration date
05/22/2006
Last updated
10/04/2017
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