Provider Demographics
NPI:1487899035
Name:SALEM RADIOLOGY LLP
Entity type:Organization
Organization Name:SALEM RADIOLOGY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-893-4352
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:STE 102
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2859
Mailing Address - Country:US
Mailing Address - Phone:603-893-4352
Mailing Address - Fax:603-894-4522
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:STE 102
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2859
Practice Address - Country:US
Practice Address - Phone:603-893-4352
Practice Address - Fax:603-894-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM15995OtherMASS BCBS