Organization Name: | IMAGING ASSOCIATES OF WESTERN MARYLAND, LP |
NPI Number: | 1003865510 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONNA LEIGH BURCH (CREDENTIALING SPECIALIST) |
Mailing Address: | 110 Baughmans Ln Suite 120 Frederick |
State: | MD US |
Postal Code: | 217024011 |
Phone Number: | 3016620077 |
Fax Number: | 3016621034 |
NPI Enumeration Date: | 05/10/2006 |
NPI Last Update Date: | 03/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 293D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Laboratories |
Taxonomy Classification: | Physiological Laboratory |
Taxonomy Specialization: | |
Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |