Provider Demographics
NPI:1275667933
Name:BASELINE ULTRASOUND,INC
Entity Type:Organization
Organization Name:BASELINE ULTRASOUND,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:A
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:RCIS,RVT,RCS,RCPT
Authorized Official - Phone:704-523-1122
Mailing Address - Street 1:3706 SELWYN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3540
Mailing Address - Country:US
Mailing Address - Phone:704-523-1122
Mailing Address - Fax:704-521-9242
Practice Address - Street 1:3706 SELWYN AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3540
Practice Address - Country:US
Practice Address - Phone:704-523-1122
Practice Address - Fax:704-521-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2881814Medicare ID - Type Unspecified