Organization
MECKLENBURG DIAGNOSTIC IMAGING LLC
Active
Other names
North Carolina Diagnostic Imaging - Monroe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization
Contact information
Practice address
1309 E SUNSET DR, MONROE, NC 28112-4324
(704) 225-8674
(704) 225-7226
Mailing address
PO BOX 933393, ATLANTA, GA 31193-0001
(866) 659-1211
(336) 774-1751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017M8
BCBS NC
NC
01
—
153718702
DOL
NC
05
—
5902728
—
NC
05
—
NPB299
—
SC
01
—
P00315955
MEDICARE RR
—
05
—
SL0074
—
SC
Enumeration date
05/04/2006
Last updated
04/01/2009
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