Healthcare Provider Details

I. General information

NPI: 1639497308
Provider Name (Legal Business Name): MAJORMEDICAL LLC PORTABLE DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8241 GEORGIA AVE SUITE 102
SILVER SPRING MD
20910-4510
US

IV. Provider business mailing address

2129 CLARK PL
SILVER SPRING MD
20910-1175
US

V. Phone/Fax

Practice location:
  • Phone: 301-585-1833
  • Fax: 240-235-3898
Mailing address:
  • Phone: 301-585-1833
  • Fax: 240-235-3898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0064592
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberD0064592
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberMD036021
License Number StateDC

VIII. Authorized Official

Name: DR. MARK MAJOR
Title or Position: OWNER/CEO
Credential: M.D.
Phone: 301-585-1833