Provider Demographics
NPI:1275801631
Name:MRI CONSULTANTS LEWES
Entity Type:Organization
Organization Name:MRI CONSULTANTS LEWES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-566-6600
Mailing Address - Street 1:17252 N VILLAGE MAIN BLVD STE 9
Mailing Address - Street 2:FIVE POINTS SHOPPING CENTER
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6292
Mailing Address - Country:US
Mailing Address - Phone:302-566-8600
Mailing Address - Fax:888-677-7145
Practice Address - Street 1:1 CENTURIAN DR STE 107
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2154
Practice Address - Country:US
Practice Address - Phone:302-295-3367
Practice Address - Fax:302-999-9897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003457261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)