Healthcare Provider Details
I. General information
NPI: 1609980283
Provider Name (Legal Business Name): DR. SWARTZ IMAGING OF MARYLAND
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2006
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4600 WILKENS AVE SUITE 103
BALTIMORE MD
21229-4843
US
IV. Provider business mailing address
PO BOX 768
NEW YORK NY
10018-0025
US
V. Phone/Fax
- Phone: 410-360-2233
- Fax: 410-360-2234
- Phone: 410-360-2233
- Fax: 410-360-2234
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MAURY
L.
ROSENBERG
Title or Position: PRESIDENT
Credential:
Phone: 410-360-2233