Healthcare Provider Details

I. General information

NPI: 1437234655
Provider Name (Legal Business Name): METROPOLITAN RADIOLOGY ASSOC CHTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6128 BRANDON AVENUE SUITE 205
SPRINGFIELD VA
22150
US

IV. Provider business mailing address

4700 BERWYN HOUSE RD SUITE 208
COLLEGE PARK MD
20740
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-8820
  • Fax: 703-569-8786
Mailing address:
  • Phone: 301-220-0150
  • Fax: 301-220-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LOIS I WILLIAMS
Title or Position: BILLING MANAGER
Credential:
Phone: 301-220-0150