Provider Demographics
NPI:1588229918
Name:SYNERGY RADIOLOGY, LLC
Entity Type:Organization
Organization Name:SYNERGY RADIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARVAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-297-5207
Mailing Address - Street 1:2200 CENTURY PKWY NE STE 600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3116
Mailing Address - Country:US
Mailing Address - Phone:404-296-5887
Mailing Address - Fax:404-297-5237
Practice Address - Street 1:6025 PROFESSIONAL PKWY STE 104
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5610
Practice Address - Country:US
Practice Address - Phone:470-412-6300
Practice Address - Fax:470-412-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology