Healthcare Provider Details

I. General information

NPI: 1184647067
Provider Name (Legal Business Name): COMPUTED TOMOGRAPHY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N BEAUREGARD ST SUITE 200
ALEXANDRIA VA
22311-1739
US

IV. Provider business mailing address

2001 N BEAUREGARD ST SUITE 200
ALEXANDRIA VA
22311-1739
US

V. Phone/Fax

Practice location:
  • Phone: 703-824-3200
  • Fax: 703-824-3522
Mailing address:
  • Phone: 703-824-3200
  • Fax: 703-824-3522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL FRIEDMAN
Title or Position: PRESIDENT
Credential:
Phone: 703-824-3200