| Name | Value |
|---|---|
| PROVIDER TYPE | Allopathic & Osteopathic Physicians |
| CLASSIFICATION | Radiology |
| DEFINITION | A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| AREA OF SPECIALIZATION | Neuroradiology |
| STATUS | Active |
| VA CODE | V183004 |
| X12 CODE | 2085N0700X |
| SPECIALTY CODE | 30 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252051 |
| EFFECTIVE DATE/TIME |
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