NORTHWEST DIAGNOSTIC IMAGING INC NPI 1114908621

NPI Information

NPI: 1114908621
Provider Name: NORTHWEST DIAGNOSTIC IMAGING, INC

Doing Business As: LAWRENCEVILLE OPEN MRI

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
600 PROFESSIONAL DR
SUITE 100
LAWRENCEVILLE, GA
ZIP 30045
Phone: (770) 963-4445
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NORTHWEST DIAGNOSTIC IMAGING, INC is a diagnostic radiology radiology in Lawrenceville, GA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. NORTHWEST DIAGNOSTIC IMAGING, INC NPI is 1114908621. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lawrenceville Open Mri.

The provider's business location address is:

600 PROFESSIONAL DR
SUITE 100
LAWRENCEVILLE, GA
ZIP 30045-651
Phone: (770) 963-4445
Fax: (770) 963-5285

The provider's authorized official is Daniel J Schaefer .
The authorized official title is Coo and has the following contact phone number (770) 300-0101.

The enumeration date for this NPI number is 11/10/2005 and was last updated on 5/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology		GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	226870823	OTHER	GEORGIA	US DEPARTMENT OF LABOR
2	CH7800	OTHER	GEORGIA	RAILROAD MEDICARE
3	=========A	MEDICARE PIN	GEORGIA
4	=========029	OTHER	GEORGIA	BLUE CROSS GEORGIA
5	DA0357	OTHER	GEORGIA	RAILROAD MEDICARE
6	=========131	OTHER	GEORGIA	UHC
7	=========027	OTHER	GEORGIA	TRICARE
8	CA0798	OTHER	GEORGIA	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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