Provider Demographics
NPI:1194138289
Name:MARYLAND RADIOLOGY ASSOCIATES
Entity type:Organization
Organization Name:MARYLAND RADIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OBI
Authorized Official - Middle Name:O
Authorized Official - Last Name:NOBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-984-9009
Mailing Address - Street 1:11400 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3004
Mailing Address - Country:US
Mailing Address - Phone:301-984-9009
Mailing Address - Fax:301-984-3042
Practice Address - Street 1:11400 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3004
Practice Address - Country:US
Practice Address - Phone:301-984-9009
Practice Address - Fax:301-984-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Single Specialty