SOUTHEASTERN RADIOLOGY PA NPI 1669476453

NPI Information

  • NPI: 1669476453
  • Provider Name: SOUTHEASTERN RADIOLOGY PA
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 3801 W MARKET ST
    GREENSBORO, NC
    ZIP 27407
  • Phone: (336) 852-3300

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NPI Details

SOUTHEASTERN RADIOLOGY PA is a diagnostic radiology radiology in Greensboro, NC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SOUTHEASTERN RADIOLOGY PA NPI is 1669476453. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3801 W MARKET ST
GREENSBORO, NC
ZIP 27407-301
Phone: (336) 852-3300
Fax: (336) 852-0651

The provider's authorized official is Dallas Aaron Smith .
The authorized official title is President and has the following contact phone number (336) 852-3300.

The enumeration date for this NPI number is 6/9/2005 and was last updated on 12/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic Radiology400555NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12314473MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
2890252KMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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