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General NPI Number Information
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NPI Number | 1760628358
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Entity Type | Organization
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Legal Business Name | MARITIME RADIOLOGY ASSOCIATES PC
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 194 E MAIN ST
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City | FORT KENT
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State | ME
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Zip | 04743-1428
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Country | US
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Telephone | 207-834-3155
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Fax | 443-274-2589
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Provider Business Mailing Address
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Address Line | 251 NAJOLES RD STE A
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2519
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Country | US
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Telephone | 443-274-2888
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Fax | 443-274-2391
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. GLAUCO MICHAEL MARESCA
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Credential | M.D.
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Telephone | 315-265-4924
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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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