Healthcare Provider Details

I. General information

NPI: 1114982808
Provider Name (Legal Business Name): DIAGNOSTIC IMAGING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 MEDICAL CAMPUS RD SUITE 204
HAGERSTOWN MD
21742-6700
US

IV. Provider business mailing address

10715 DOWNSVILLE PIKE STE 103
HAGERSTOWN MD
21740-7240
US

V. Phone/Fax

Practice location:
  • Phone: 301-714-4200
  • Fax: 301-714-4201
Mailing address:
  • Phone: 301-739-6147
  • Fax: 301-739-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number StateMD

VIII. Authorized Official

Name: MR. MICHAEL S ZAMPELLI
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 301-739-6147