Provider Demographics
NPI:1134645351
Name:M & B IMAGING, PC
Entity Type:Organization
Organization Name:M & B IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARVAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-296-5887
Mailing Address - Street 1:PO BOX 933367
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-3367
Mailing Address - Country:US
Mailing Address - Phone:404-296-5887
Mailing Address - Fax:
Practice Address - Street 1:2485 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-1202
Practice Address - Country:US
Practice Address - Phone:404-296-5887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty