Provider Demographics
NPI:1689983777
Name:PEACHTREE MRI LLC
Entity Type:Organization
Organization Name:PEACHTREE MRI LLC
Other - Org Name:PEACHTREE DIAGNOSTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:IMRAN
Authorized Official - Last Name:NIAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-964-3569
Mailing Address - Street 1:1380 CARLYSLE PARK DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2249
Mailing Address - Country:US
Mailing Address - Phone:404-964-3569
Mailing Address - Fax:866-487-7900
Practice Address - Street 1:1380 CARLYSLE PARK DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2249
Practice Address - Country:US
Practice Address - Phone:404-964-3569
Practice Address - Fax:866-487-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)