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General NPI Number Information
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NPI Number | 1679348023
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Entity Type | Organization
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Legal Business Name | KINGSPOINT RADIOLOGY
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 14419 DOLBROOK LN
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City | BOWIE
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State | MD
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Zip | 20721-3219
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Country | US
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Telephone | 301-408-8684
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Fax |
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Provider Business Mailing Address
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Address Line | 14419 DOLBROOK LN
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City | BOWIE
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State | MD
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Zip | 20721-3219
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALICE ESUNGE
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Credential |
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Telephone | 301-408-8684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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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 | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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