Healthcare Provider Details

I. General information

NPI: 1346202751
Provider Name (Legal Business Name): MONTGOMERY-COMMUNITY MAGNETIC IMAGING CNTR LTD PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 05/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 ASPEN HILL RD SUITE 200
ROCKVILLE MD
20853-2853
US

IV. Provider business mailing address

PO BOX 64940
BALTIMORE MD
21264-4940
US

V. Phone/Fax

Practice location:
  • Phone: 301-438-5150
  • Fax: 301-460-0199
Mailing address:
  • Phone: 301-438-5150
  • Fax: 301-460-0199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAUL S SCHAEFER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-438-5150