Healthcare Provider Details
I. General information
NPI: 1942392667
Provider Name (Legal Business Name): METROPOLITAN RADIOLOGY ASSOCIATES CHARTERED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2006
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 VARNUM ST NE
WASHINGTON DC
20017
US
IV. Provider business mailing address
4700 BERWYN HOUSE RD STE 208
COLLEGE PARK MD
20740-2474
US
V. Phone/Fax
- Phone: 202-269-7000
- Fax:
- Phone: 301-220-0150
- Fax: 301-220-1032
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
CHRISTINE
S
MULLEN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 301-614-0595