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General NPI Number Information
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NPI Number | 1417106998
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Entity Type | Organization
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Legal Business Name | FAMILY MRI INC.
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 75 THOMAS JOHNSON DR SUITE F
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City | FREDERICK
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State | MD
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Zip | 21702-4895
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Country | US
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Telephone | 301-631-3674
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Fax | 301-631-3675
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Provider Business Mailing Address
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Address Line | 75 THOMAS JOHNSON DR SUITE F
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City | FREDERICK
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State | MD
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Zip | 21702-4895
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Country | US
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Telephone | 301-631-3674
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Fax | 301-631-3675
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT M. KIANETSKI
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Credential |
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Telephone | 240-405-6307
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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 |
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License Number State |
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