Provider Demographics
NPI:1942438874
Name:MDS DIGITAL X-RAY INC
Entity Type:Organization
Organization Name:MDS DIGITAL X-RAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUNNER
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-626-0800
Mailing Address - Street 1:5620 E FOWLER AVE
Mailing Address - Street 2:STE F
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2372
Mailing Address - Country:US
Mailing Address - Phone:847-626-0800
Mailing Address - Fax:847-626-0817
Practice Address - Street 1:5620 E FOWLER AVE
Practice Address - Street 2:STE F
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-2372
Practice Address - Country:US
Practice Address - Phone:847-626-0800
Practice Address - Fax:847-626-0817
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MDS DIGITAL X-RAY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-30
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty