1972793453 NPI number — RADIOLOGY OF HILTON HEAD LLC

Table of content: DR. DEBORAH L. MILLER PH.D. (NPI 1861584732)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972793453 NPI number — RADIOLOGY OF HILTON HEAD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RADIOLOGY OF HILTON HEAD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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Provider Other Middle Name:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1972793453
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2555 PONCE DE LEON BLVD
Provider Second Line Business Mailing Address:
4TH FLOOR
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33134-6010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-702-5135
Provider Business Mailing Address Fax Number:
305-441-2144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 HOSPITAL CENTER BLVD
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
HILTON HEAD
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29926-2738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-689-8278
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HEWES
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
843-689-8278

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)