Healthcare Provider Details

I. General information

NPI: 1750432159
Provider Name (Legal Business Name): KORANGY RADIOLOGY & ASSOC. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 REISTERSTOWN RD SUITE 305
BALTIMORE MD
21215-2686
US

IV. Provider business mailing address

PO BOX 5847
BALTIMORE MD
21282-5847
US

V. Phone/Fax

Practice location:
  • Phone: 410-432-4340
  • Fax: 410-764-0647
Mailing address:
  • Phone: 410-764-0912
  • Fax: 410-764-0647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL KORANGY
Title or Position: CFO
Credential:
Phone: 410-764-0912