Provider Demographics
NPI:1699711093
Name:RADIOLOGIC ASSOCIATES OF FREDERICKSBURG LTD
Entity type:Organization
Organization Name:RADIOLOGIC ASSOCIATES OF FREDERICKSBURG LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-361-1000
Mailing Address - Street 1:PO BOX 825855
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-5855
Mailing Address - Country:US
Mailing Address - Phone:540-361-1000
Mailing Address - Fax:540-361-7010
Practice Address - Street 1:1001 SAM PERRY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4453
Practice Address - Country:US
Practice Address - Phone:540-741-1571
Practice Address - Fax:540-361-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA015792OtherANTHEM
VA3171OtherCAREFIRST
VA=========OtherCIGNA
VA=========OtherTRICARE
VA=========OtherFIRST HEALTH
VA=========OtherVIRGINIA HEALTH NETWORK
VA=========OtherUNITED HEALTHCARE
VA217998OtherMAMSI
VA=========OtherTRICARE
VA015792OtherANTHEM
VA=========OtherVIRGINIA HEALTH NETWORK
CB4588Medicare PIN