Provider Demographics
NPI:1184953226
Name:MARQUIS DIAGNOSTIC IMAGING OF NORTH CAROLINA, LLC
Entity type:Organization
Organization Name:MARQUIS DIAGNOSTIC IMAGING OF NORTH CAROLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-272-7771
Mailing Address - Street 1:44000 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1125
Mailing Address - Country:US
Mailing Address - Phone:586-412-4000
Mailing Address - Fax:586-412-4102
Practice Address - Street 1:1000 CENTRE PARK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1265
Practice Address - Country:US
Practice Address - Phone:586-412-4000
Practice Address - Fax:586-412-4102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2880807Medicare PIN