Healthcare Provider Details
I. General information
NPI: 1376617068
Provider Name (Legal Business Name): MILLENNIUM SCAN INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2006
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2440 M ST NW SUITE 203
WASHINGTON DC
20037-1404
US
IV. Provider business mailing address
2440 M ST NW SUITE 203
WASHINGTON DC
20037-1404
US
V. Phone/Fax
- Phone: 202-775-9710
- Fax: 202-775-9720
- Phone: 202-775-5111
- Fax: 202-775-9720
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SALIM
AZIZ
Title or Position: OWNER
Credential:
Phone: 202-775-5111