Healthcare Provider Details

I. General information

NPI: 1013070457
Provider Name (Legal Business Name): UNITED RADIOLOGY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1147 S HANOVER ST
BALTIMORE MD
21230-3717
US

IV. Provider business mailing address

6615 REISTERSTOWN RD STE 305
BALTIMORE MD
21215-2686
US

V. Phone/Fax

Practice location:
  • Phone: 410-752-2777
  • Fax: 410-625-9024
Mailing address:
  • Phone: 410-764-0912
  • Fax: 410-764-0647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

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