Provider Demographics
NPI:1164737755
Name:MEDISCAN IMAGING INC
Entity Type:Organization
Organization Name:MEDISCAN IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-535-1188
Mailing Address - Street 1:4822 ALBEMARLE RD
Mailing Address - Street 2:#204
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6668
Mailing Address - Country:US
Mailing Address - Phone:704-535-1188
Mailing Address - Fax:
Practice Address - Street 1:4822 ALBEMARLE RD
Practice Address - Street 2:#204
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6668
Practice Address - Country:US
Practice Address - Phone:704-535-1188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-08
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile