Provider Demographics
NPI:1841369600
Name:MID-DELAWARE IMAGING P.A.
Entity type:Organization
Organization Name:MID-DELAWARE IMAGING P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHENDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-734-9888
Mailing Address - Street 1:710 SOUTH QUEEN STREET
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3567
Mailing Address - Country:US
Mailing Address - Phone:302-734-9888
Mailing Address - Fax:302-734-2780
Practice Address - Street 1:710 SOUTH QUEEN STREET
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3567
Practice Address - Country:US
Practice Address - Phone:302-734-9888
Practice Address - Fax:302-734-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1 00017922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000228702Medicaid
DE000228702Medicaid
615180Medicare ID - Type Unspecified
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