Healthcare Provider Details

I. General information

NPI: 1093907438
Provider Name (Legal Business Name): NYQUIST VASCULAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 OLD COURT RD STE 206
PIKESVILLE MD
21208-6415
US

IV. Provider business mailing address

8708 JULIA FLOWERS CT
RANDALLSTOWN MD
21133-3700
US

V. Phone/Fax

Practice location:
  • Phone: 443-333-4770
  • Fax: 443-333-4769
Mailing address:
  • Phone: 443-333-4770
  • Fax: 443-333-4769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License NumberR45875
License Number StateMD

VIII. Authorized Official

Name: MARK KENDALL BATES
Title or Position: MANAGING PARTNER
Credential: RVT
Phone: 443-758-7611