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General NPI Number Information
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NPI Number | 1073511655
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Entity Type | Organization
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Legal Business Name | MARYLAND DIAGNOSTIC SERVICES, INC.
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 101 W RIDGELY RD 7B
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City | TIMONIUM
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State | MD
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Zip | 21093-5101
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Country | US
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Telephone | 410-628-6046
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Fax |
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Provider Business Mailing Address
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Address Line | 853 SECOND STREET PIKE B104
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City | RICHBORO
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State | PA
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Zip | 18954-1082
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Country | US
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Telephone | 215-354-1260
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Fax | 215-354-1266
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL COREN
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Credential |
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Telephone | 215-354-1260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246XC2903X
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Taxonomy Name | Vascular Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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