Provider Demographics
NPI:1437572310
Name:MEDICAL DIAGNOSTIC TESTING INC
Entity Type:Organization
Organization Name:MEDICAL DIAGNOSTIC TESTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-388-6686
Mailing Address - Street 1:205 E BUTTERFIELD RD
Mailing Address - Street 2:SUITE 159
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5103
Mailing Address - Country:US
Mailing Address - Phone:404-388-6686
Mailing Address - Fax:
Practice Address - Street 1:205 E BUTTERFIELD RD
Practice Address - Street 2:SUITE 159
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5103
Practice Address - Country:US
Practice Address - Phone:404-388-6686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)