Provider Demographics
NPI:1821338153
Name:MINUTEMEN RADIOLOGY INC
Entity Type:Organization
Organization Name:MINUTEMEN RADIOLOGY INC
Other - Org Name:DOCTORS OF DIAGNOSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANG
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-223-6793
Mailing Address - Street 1:4551 JEFFERSON POINTE LN
Mailing Address - Street 2:SUITE # 5 .
Mailing Address - City:PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23875-1478
Mailing Address - Country:US
Mailing Address - Phone:253-223-6793
Mailing Address - Fax:
Practice Address - Street 1:4551 JEFFERSON POINTE LN
Practice Address - Street 2:SUITE # 5 .
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875-1478
Practice Address - Country:US
Practice Address - Phone:253-223-6793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-23
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012513622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty