MEDICARE: WASHINGTON OPEN MRI INC

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center	M370	MD
2	261Q00000X	Clinic/Center	M370	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	472315	OTHER	DC	MEDICARE

General Provider Information

NPI Number	:	1336625516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON OPEN MRI INC

Provider Business Mailing Address
First Line	:	15005 SHADY GROVE RD STE 110
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-6341
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9135 PISCATAWAY RD STE 106
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-2548
Country	:	US
Telephone Number	:	301-923-0034
Fax Number	:

Authorized Official
Title or Position	:	D/O
Name	:	ALYSON MOST
Credential	:
Telephone Number	:	301-424-4888

Provider Enumeration Date	:	07/11/2018
Last Update Date	:	07/11/2018

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Directions to “WASHINGTON OPEN MRI INC ” Practice Location

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