Healthcare Provider Details

I. General information

NPI: 1679764153
Provider Name (Legal Business Name): WASHINGTON RADIOLOGY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 K ST NW SUITE 900
WASHINGTON DC
20037-1810
US

IV. Provider business mailing address

3015 WILLIAMS DR SUITE 200
FAIRFAX VA
22031-4623
US

V. Phone/Fax

Practice location:
  • Phone: 202-223-9722
  • Fax: 202-659-2819
Mailing address:
  • Phone: 703-641-9133
  • Fax: 703-280-5098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: IAN LANDE
Title or Position: PRESIDENT
Credential: MD
Phone: 703-641-9133