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General NPI Number Information
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NPI Number | 1922098052
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Entity Type | Organization
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Legal Business Name | IMAGING CENTER MARYLAND, LLC
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 8827 CENTRE PARK DR
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City | COLUMBIA
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State | MD
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Zip | 21045-2156
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Country | US
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Telephone | 410-772-3232
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Fax | 410-772-3299
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Provider Business Mailing Address
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Address Line | 8827 CENTRE PARK DR
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City | COLUMBIA
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State | MD
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Zip | 21045-2156
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Country | US
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Telephone | 410-772-3232
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Fax | 410-772-3299
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Authorized Official
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Title or Position | SR DIRECTOR
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Name | KAREN AMAYA
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Credential |
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Telephone | 513-924-5174
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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 | M227
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License Number State | MD
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