Provider Demographics
NPI:1992869754
Name:UNITED RADIOLOGY SERVICES, LLC
Entity type:Organization
Organization Name:UNITED RADIOLOGY SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KORANGY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-764-0912
Mailing Address - Street 1:6615 REISTERSTOWN RD
Mailing Address - Street 2:STE 305
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2686
Mailing Address - Country:US
Mailing Address - Phone:410-764-0912
Mailing Address - Fax:410-764-0647
Practice Address - Street 1:4B NORTH AVE
Practice Address - Street 2:NORTH PARK CENTER/ STE 300
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2329
Practice Address - Country:US
Practice Address - Phone:410-838-3777
Practice Address - Fax:410-383-9646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD474POtherMEDICARE