MEDICARE: UNITED RADIOLOGY SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	474P	OTHER	MD	MEDICARE

General Provider Information

NPI Number	:	1013070457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED RADIOLOGY SERVICES, LLC

Provider Business Mailing Address
First Line	:	6615 REISTERSTOWN RD
Second Line	:	STE 305
City	:	BALTIMORE
State	:	MD
Zip	:	21215-2686
Country	:	US
Telephone Number	:	410-764-0912
Fax Number	:	410-764-0647

Provider Business Practice Location Address
First Line	:	1147 S HANOVER ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21230-3717
Country	:	US
Telephone Number	:	410-752-2777
Fax Number	:	410-625-9024

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL KORANGY
Credential	:
Telephone Number	:	410-764-0912

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	09/12/2007

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Directions to “UNITED RADIOLOGY SERVICES, LLC ” Practice Location

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