MEDICARE: ULTRASOUND ON-SITE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2085R0202X	Diagnostic Radiology Physician
2	2085U0001X	Diagnostic Ultrasound Physician
3	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1285020438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTRASOUND ON-SITE, LLC

Provider Business Mailing Address
First Line	:	6201 GREENBELT RD STE M10
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2358
Country	:	US
Telephone Number	:	301-523-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 GREENBELT RD STE M10
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2358
Country	:	US
Telephone Number	:	301-523-1500
Fax Number	:

Authorized Official
Title or Position	:	ULTRASOUND SONOGRAPHER
Name	:	MS. CHINYERE ELEONU
Credential	:	AA ULTRASOUND
Telephone Number	:	301-523-1500

Provider Enumeration Date	:	04/14/2015
Last Update Date	:	04/14/2015

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