South Atlanta Radiology Associates, P.C.
Organization Active NPI Diagnostic Radiology Physician · Riverdale, GA
NPI 1811949720 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1811949720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- SOUTH ATLANTA RADIOLOGY ASSOCIATES, P.C.
- Practice address
- 119 Upper Riverdale Rd SW
Riverdale, GA 30274-2540 - Phone
- (770) 991-1010
- NPI assigned
- May 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Balu S. Mani, MD
- Title
- Authorized Representative
- Phone
- (770) 991-1010
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Practitioners 10
-
David J Bodne, MD
-
Balu S Mani, MD
-
Rajneesh Sehgal, M.D.
-
John B Black, MD
-
Steven V Manzi, MD
-
Hal M Frederick, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040408001083 | GA | Part B Supplier - Clinic/Group Practice | 0749274272 |
Receives reassigned benefits from 5 practitioners 1 other NPI on this enrollment Practice locations: Riverdale, GA; Stockbridge, GA |
National Provider Directory
- Tax ID family
- South Atl Radiology Assoc
Locations
747 S 8th St
Ste B2
Griffin, GA 30224
Phone (770) 228-7625
50 Kelly Rd
McDonough, GA 30253
Phone (770) 957-1887
195 Fore River Pkwy
Ste 260
Portland, ME 04102
Phone (207) 553-6600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
119 Upper Riverdale Rd SW
Riverdale, GA 30274-2540
Mailing address
PO Box 2963
Kennesaw, GA 30156-9117
Phone (770) 779-2178
Other providers in Riverdale, GA
- South Atlanta Medical Care
- South Atlanta Neurology and Diagnostics, P.C.
- South Atlanta Pediatrics
- South Atlanta Psychiatry LLC
- South Atlanta Pulmonary & Critical Care Associates
- South Metro Primary Care
- South Metro Primary Care,P.C.
- South Sound Inpatient Physicians, PLLC
- Southern Crescent Hospital for Specialty Care, Inc.
- Southern Crescent Pediatrics PC
All providers in Riverdale, GA · Diagnostic Radiology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.