MIDATLANTIC DIAGNOSTIC IMAGING CENTERS LLC (NPI# 1851457246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851457246 |
| Entity Type | Organization |
| Organization Name | MIDATLANTIC DIAGNOSTIC IMAGING CENTERS LLC |
| Other Organization Name | ELICOTT OPEN MRI |
| Practice Address |
3570 Saint Johns Ln Suite 104 B Ellicott City MD 21042-4020 |
| Practice Telephone | 4104800082 |
| Mailing Telephone | 4104800082 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2008-01-09 |
| Authorized Official Name | JOHN TUCKER (PRESIDENT) |
| Authorized Official Telephone | 4104800082 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | BLUE SHIELD | 970BEL | 01 |
| DC | GHI | K676 | 01 |
| Other Name | Type Code |
|---|---|
| ELICOTT OPEN MRI | Doing Business As Name - Organization |
| Street Address |
3570 SAINT JOHNS LN SUITE 104 B |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21042-4020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891744595 | Arthur E Kurlanzik | Specialist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2006-05-09 |
| 1679041032 | Maryann Colborn | Counselor | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2018-11-05 |
| 1992017982 | Diana Gersuk | Physical Therapist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2010-07-08 |
| 1922237445 | Ashley Elizabeth Johnson | Physical Therapist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2009-07-06 |
| 1962531848 | Premier Orthopedics, P.a. | Orthopaedic Surgery | 3570 Saint Johns Ln, Frederick Crossing, Ellicott City, MD 21042-4020 | 2007-03-05 |
| 1669582375 | Kimberly Schwartz | Physical Therapist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2006-08-30 |
| 1730299264 | Kevin Young | Physical Therapist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2006-08-30 |
| 1851401400 | Khadijeh Vali | Physical Therapist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2006-08-30 |
| 1346359080 | Gerald Rogers | Physical Therapist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2006-08-29 |
| 1407964653 | Patricia Hughes | Physical Therapist | 3570 Saint Johns Ln, Ellicott City, MD 21042-4020 | 2006-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861950792 | Danielle Coliukos | Student in an Organized Health Care Education/Training Program | 3006 Fawnwood Dr, Ellicott City, MD 21042 | 2019-03-11 |
| 1700356110 | Sung Hee Moon | Acupuncturist | 9005 Chevrolet Dr #4, Ellicott City, MD 21042 | 2018-11-28 |
| 1902375009 | Sharon N Allen | Speech-Language Pathologist | Hcpss, 10910 Clarksville Pike, Ellicott City, MD 21042 | 2018-11-19 |
| 1043700412 | Samirawit Hailemariam | Registered Nurse | 9527 Liverpool Lane, Ellicott City, MD 21042 | 2018-05-11 |
| 1144771965 | Maryland Psychotherapy Services | Community/Behavioral Health | 7054 Dorsey Hall Dr., Suite 104, Ellicott City, MD 21042 | 2016-10-17 |
| 1861851321 | The Lutheran Village At Miller's Grant, Inc. | Skilled Nursing Facility | 9000 Fathers Legacy, Ellicott City, MD 21042 | 2016-02-12 |
| 1942676952 | Hyoung Keun Kim | Dentist | 10033 Baltimore Pike Suite 320, Ellicott City, MD 21042 | 2015-08-13 |
| 1356743553 | Cvs Pharmacy | Pharmacist | 3300a Centennial Lane, Ellicott City, MD 21042 | 2014-09-18 |
| 1821407719 | Zulema Roberts | Counselor | 3355 St. Johns Lane, Suite F, Ellicott City, MD 21042 | 2014-08-05 |
| 1548681638 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 3459 St. John's Lane, Suite 9, Ellicott City, MD 21042 | 2013-12-17 |
| Find all providers in zip 21042 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922597129 | Ismail Baris Turkbey | Radiology | 10 Center Drive Room B3b85, Bethesda, MD 20892-0001 | 2018-05-03 |
| 1801068879 | Nilo Avila | Radiology | 8518 Bells Ridge Ter, Potomac, MD 20854-2793 | 2008-03-30 |
| 1316119621 | Karoly Andras Viragh | Radiology | 12720 Epping Ter, Silver Spring, MD 20906-3866 | 2008-03-26 |
| 1952434409 | Robert William Seaman | Radiology | 2022 Haverford Dr, Crownsville, MD 21032-2234 | 2007-03-13 |
| 1184787517 | United Radiology Services, LLC | Radiology | 4b North Ave, Ste 300, Bel Air, MD 21014-2329 | 2006-12-18 |
| 1851359707 | Peninsula Imaging L.L.C. | Radiology | 1655 Woodbrooke Dr, Suite 101, Salisbury, MD 21804-8502 | 2006-05-02 |
| 1548232341 | Stephen Thomas Sears | Radiology | Nnmc Director of Clinical Support Services, 8901 Wisconsin Ave, Bethesda, MD 20889-0001 | 2006-02-06 |
| 1912978172 | Roy Laurence Moss | Radiology | 6605 Pebble Brooke Rd, Baltimore, MD 21209-3793 | 2006-01-27 |
| 1447246640 | Michael Spencer Gibson | Radiology | Nnmc, Radiology, 8901 Wisconsin Ave, Bethesda, MD 20889-0001 | 2005-09-22 |
| 1841782588 | Prompt Occupational Health Care | Radiology | 998 Hospitality Way Ste A, Aberdeen, MD 21001-1759 | 2018-05-30 |
| Find all providers with the same taxonomy | ||||
| City | ELLICOTT CITY |
| Zip Code | 21042 |
Please comment or provide details below to improve the information on MIDATLANTIC DIAGNOSTIC IMAGING CENTERS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.