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General NPI Number Information
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NPI Number | 1588864557
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Entity Type | Organization
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Legal Business Name | CARROLL PRECISION IMAGING CENTER
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 680 POOLE RD A
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City | WESTMINSTER
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State | MD
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Zip | 21157-6003
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Country | US
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Telephone | 410-848-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 680 POOLE RD A
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City | WESTMINSTER
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State | MD
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Zip | 21157-6003
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Country | US
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Telephone | 410-848-5250
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CHITRACHEDU NAGANNA
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Credential | MD
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Telephone | 410-848-5250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | M345
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License Number State | MD
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