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NPI Code Detail

MEDICARE: HEALTHCARE IMAGING, LLC

MEDICARE: HEALTHCARE IMAGING, 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
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1720480817
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHCARE IMAGING, LLC
Provider Business Mailing Address
First Line : 1030 N CHARLES ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21201-5443
Country : US
Telephone Number : 410-746-1912
Fax Number :
Provider Business Practice Location Address
First Line : 1030 N CHARLES ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21201-5443
Country : US
Telephone Number : 410-746-1912
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : IRFAN SHAFIQUE
Credential : M.D.
Telephone Number : 410-740-1912
Provider Enumeration Date : 09/19/2014
Last Update Date : 03/24/2015

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