Healthcare Provider Details
I. General information
NPI: 1255220984
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF MARYLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14995 SHADY GROVE RD STE 300
ROCKVILLE MD
20850-8726
US
IV. Provider business mailing address
14995 SHADY GROVE RD STE 140
ROCKVILLE MD
20850-8734
US
V. Phone/Fax
- Phone: 301-217-0500
- Fax: 301-217-0501
- Phone: 301-217-0500
- Fax: 301-217-0501
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207U00000X |
| Taxonomy | Nuclear Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KETAN
NALIN
NARAN
Title or Position: MEMBER/PHYSICIAN
Credential: M.D.
Phone: 301-217-0500