Provider Demographics
NPI:1871734558
Name:MEDICAL SONOIMAGING, LLC
Entity type:Organization
Organization Name:MEDICAL SONOIMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ULTRASONOGRAPHER
Authorized Official - Prefix:
Authorized Official - First Name:RAVINDRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:MALAPUR
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS,DGO,MD,ARDMS
Authorized Official - Phone:304-342-0556
Mailing Address - Street 1:250 EUREKA RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-2126
Mailing Address - Country:US
Mailing Address - Phone:304-342-0556
Mailing Address - Fax:304-342-0556
Practice Address - Street 1:250 EUREKA RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-2126
Practice Address - Country:US
Practice Address - Phone:304-342-0556
Practice Address - Fax:304-342-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2085U0001X261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology