Provider Demographics
NPI:1225227309
Name:PC MEDICAL DIAGNOSTICS
Entity Type:Organization
Organization Name:PC MEDICAL DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:PASHA
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-672-6000
Mailing Address - Street 1:610 N FAYETTEVILLE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-4670
Mailing Address - Country:US
Mailing Address - Phone:336-672-6000
Mailing Address - Fax:336-672-6001
Practice Address - Street 1:610 N FAYETTEVILLE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4670
Practice Address - Country:US
Practice Address - Phone:336-672-6000
Practice Address - Fax:336-672-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty