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General NPI Number Information
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NPI Number | 1265647176
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Entity Type | Organization
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Legal Business Name | CAPITAL IMAGING LLC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 04/01/2010
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Provider Practice Location Address
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Address Line | 4927 AUBURN AVE
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City | BETHESDA
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State | MD
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Zip | 20814-2641
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Country | US
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Telephone | 301-718-3411
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Fax | 301-718-0805
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Provider Business Mailing Address
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Address Line | 4927 AUBURN AVE
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City | BETHESDA
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State | MD
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Zip | 20814-2641
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Country | US
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Telephone | 301-718-3411
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Fax | 301-718-0805
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW KOMISKE
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Credential |
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Telephone | 301-519-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M225
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License Number State | MD
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