Provider Demographics
NPI:1003866583
Name:RADIOLOGY GROUP LLC
Entity Type:Organization
Organization Name:RADIOLOGY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAND
Authorized Official - Middle Name:PANKAJ
Authorized Official - Last Name:LALAJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-946-9633
Mailing Address - Street 1:3340 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 2025
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1000
Mailing Address - Country:US
Mailing Address - Phone:404-946-9633
Mailing Address - Fax:404-946-2868
Practice Address - Street 1:3475 PIEDMONT RD NE STE 1150
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-3003
Practice Address - Country:US
Practice Address - Phone:049-469-6304
Practice Address - Fax:404-506-8491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CX82Medicare PIN
LA5CU20Medicare PIN
GAGRP6529Medicare PIN