Basic Information
| Provider Information | |||||||||
| NPI: | 1952377418 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCMONAGLE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 KINGSLEY LN | ||||||||
| Address2: | SUITE 305 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235054614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578895942 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 110 KINGSLEY LN | ||||||||
| Address2: | SUITE 305 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235054614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578895942 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2006 | ||||||||
| LastUpdateDate: | 07/15/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 116018805 | VA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 208D00000X | 01056685A | IN | N | Allopathic & Osteopathic Physicians | General Practice | 2085R0202X | 2010-00619 | NC | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.