Unknown Individual – Diagnostic Radiology Physician, NPI 1790760890
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Preston Ridge Road, Country Place, Preston Ridge, Alpharetta, Fulton County, Georgia, 300009, United States
CREDENTIALING DEPT
ALPHARETTA, GA 300055462
Phone: (770) 300-0101
Fax: (770) 300-0429
Type: Mailing
425, Broad Street Southeast, Green Street-Brenau Historic District, Gainesville, Hall County, Georgia, 30501, United States
SUITE 102
GAINESVILLE, GA 305013725
Phone: (770) 718-9776
Fax: (770) 718-1910
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30005)
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