Healthcare Provider Details

I. General information

NPI: 1932314507
Provider Name (Legal Business Name): KETAN NALIN NARAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 11/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 DEFENSE HWY CHESAPEAKE MEDICAL IMAGING
ANNAPOLIS MD
21401-7069
US

IV. Provider business mailing address

122 DEFENSE HWY CHESAPEAKE MEDICAL IMAGING
ANNAPOLIS MD
21401-7069
US

V. Phone/Fax

Practice location:
  • Phone: 410-571-0350
  • Fax: 410-571-9348
Mailing address:
  • Phone: 410-571-0350
  • Fax: 410-571-9348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD55875
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: