MEDICARE: CENTER FOR INTERVENTIONAL MEDICINE, 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	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1760653448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR INTERVENTIONAL MEDICINE, LLC

Provider Business Mailing Address
First Line	:	251 NATIONAL HARBOR BLVD STE 104
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-1052
Country	:	US
Telephone Number	:	866-800-2346
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 NATIONAL HARBOR BLVD STE 104
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-1052
Country	:	US
Telephone Number	:	866-800-2346
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MEGHAL R ANTANI
Credential	:	MD
Telephone Number	:	866-800-2346

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	10/19/2023

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