National Provider Identifier Database

MOUNTAIN TELERAD PLLC
Radiologic Technologist

A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.


Contact Information

MOUNTAIN TELERAD, PLLC
4519 ENTERPRISE WAY
CALDWELL, ID83605
Phone: 208-455-7482
Fax: 208-455-7538
Website:
Specialty Taxonomy Code
* Radiologic Technologist 247100000X

* Indicates primary specialty

NPI Profile & details for MOUNTAIN TELERAD, PLLC

NPI Number 1821280371
Legal business name
LBN
MOUNTAIN TELERAD, PLLC
Authorized official MICHEAL JOHNSON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 08/17/2007
Last updated 08/17/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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