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General NPI Number Information
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NPI Number | 1811162050
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Entity Type | Organization
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Legal Business Name | MARYLAND MRI L.L.C.
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 7409 VAN DUSEN RD
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City | LAUREL
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State | MD
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Zip | 20707-6400
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Country | US
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Telephone | 301-483-4440
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Fax | 301-483-7982
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Provider Business Mailing Address
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Address Line | 7409 VAN DUSEN RD
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City | LAUREL
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State | MD
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Zip | 20707-6400
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Country | US
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Telephone | 301-483-4440
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Fax | 301-483-7982
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JEAN EDMOND GAETJENS
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Credential |
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Telephone | 301-483-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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