Provider Demographics
NPI:1821000605
Name:SALEM RADIOLOGY LLP
Entity Type:Organization
Organization Name:SALEM RADIOLOGY LLP
Other - Org Name:NORTH ANDOVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HANNON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-893-4352
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:STE 102
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-893-4352
Mailing Address - Fax:603-894-4522
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:STE 102
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079
Practice Address - Country:US
Practice Address - Phone:603-893-4352
Practice Address - Fax:603-894-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM12286OtherBS
NH30814372Medicaid
NH81304113Medicaid
NHNH4113Medicare ID - Type Unspecified
MAM15995Medicare ID - Type Unspecified