Provider Demographics
NPI:1801831961
Name:MOBILE ULTRASOUND SERVICES LLC
Entity Type:Organization
Organization Name:MOBILE ULTRASOUND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:AVVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-525-4659
Mailing Address - Street 1:152 LEMAY FERRY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-1253
Mailing Address - Country:US
Mailing Address - Phone:800-354-1088
Mailing Address - Fax:314-631-4491
Practice Address - Street 1:2913 SW BRIDLEWOOD CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2473
Practice Address - Country:US
Practice Address - Phone:816-525-4659
Practice Address - Fax:314-631-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty