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General NPI Number Information
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NPI Number | 1912984089
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Entity Type | Organization
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Legal Business Name | RADIOLOGY PROFESSIONALS, PA
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 175 FORE RIVER PKWY
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City | PORTLAND
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State | ME
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Zip | 04102-2779
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Country | US
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Telephone | 207-879-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 986520 DEPARTMENT 250
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City | BOSTON
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State | MA
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Zip | 02298-6520
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Country | US
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Telephone | 207-784-2554
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Fax | 207-777-1439
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID LANGDON
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Credential | MD
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Telephone | 207-879-3000
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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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