Organization Name: | INTERMED IMAGING A MEDICAL CORPORATION |
NPI Number: | 1649575671 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WALTER PRESTON MAYNARD (PRESIDENT/RADIOLOGIST) |
Mailing Address: | 880 E Tuolumne Rd Turlock |
State: | CA US |
Postal Code: | 953821548 |
Phone Number: | 3106719754 |
Fax Number: | 3106713916 |
NPI Enumeration Date: | 01/24/2011 |
NPI Last Update Date: | 01/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | C33935 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |