Provider Demographics
NPI:1700060456
Name:MCGRAW MOBILE XRAY, INC
Entity Type:Organization
Organization Name:MCGRAW MOBILE XRAY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-321-0006
Mailing Address - Street 1:726 RAMSEY ST STE 10
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-4705
Mailing Address - Country:US
Mailing Address - Phone:910-321-0006
Mailing Address - Fax:
Practice Address - Street 1:726 RAMSEY ST STE 10
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4705
Practice Address - Country:US
Practice Address - Phone:910-321-0006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409816Medicaid
NC0227FOtherBCBS
NC0227FOtherBCBS