Healthcare Provider Details

I. General information

NPI: 1154351021
Provider Name (Legal Business Name): ASSOCIATES IN RADIATION MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4831 TESLA DR STE A-C
BOWIE MD
20715-4323
US

IV. Provider business mailing address

PO BOX 418837
BOSTON MA
02241-8837
US

V. Phone/Fax

Practice location:
  • Phone: 301-805-6860
  • Fax: 301-805-0755
Mailing address:
  • Phone: 888-846-5527
  • Fax: 607-324-2369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberD04119897
License Number StateMD

VIII. Authorized Official

Name: MATTHEW L SNYDER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 888-846-5527