| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Radiology |
| DEFINITION | A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| AREA OF SPECIALIZATION | Body Imaging |
| STATUS | Active |
| VA CODE | V183001 |
| X12 CODE | 2085B0100X |
| SPECIALTY CODE | 30 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252042 |
| EFFECTIVE DATE/TIME |
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