Healthcare Provider Details

I. General information

NPI: 1740537612
Provider Name (Legal Business Name): TRI-STATE MRI & IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2012
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E PULASKI HWY
ELKTON MD
21921-6435
US

IV. Provider business mailing address

PO BOX 1040
ELKTON MD
21922-1040
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-0590
  • Fax: 410-392-9408
Mailing address:
  • Phone: 410-398-0590
  • Fax: 410-392-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ZAHID ASLAM
Title or Position: OWNER
Credential: M.D.
Phone: 443-350-3519