Healthcare Provider Details

I. General information

NPI: 1780792978
Provider Name (Legal Business Name): RADIOLOGIC ASSOCIATES OF FREDERICKSBURG LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 SPOTSYLVANIA AVE STE 203
FREDERICKSBURG VA
22408-8609
US

IV. Provider business mailing address

PO BOX 825855
PHILADELPHIA PA
19182-5855
US

V. Phone/Fax

Practice location:
  • Phone: 540-361-1000
  • Fax: 540-361-7010
Mailing address:
  • Phone: 540-361-1000
  • Fax: 540-361-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER MEYER
Title or Position: PRESIDENT
Credential: MD
Phone: 540-361-1000