Organization · NPI-2
Advanced Radiology P A
Radiology, Diagnostic Radiology · Glen Burnie, MD
NPI number1477370336
StatusActive
Last updated in NPPESSep 23, 2024
Details
- NPI
- 1477370336
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Radiology P A
- Organization subpart
- Yes
- Enumeration date
- Sep 23, 2024
- Certification date
- Sep 23, 2024
- Last updated
- Sep 23, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | – | – | Yes |
| 207U00000X | Nuclear Medicine | – | – | |
| 2085R0204X | Radiology, Vascular & Interventional Radiology | – | – |
Other names
- Adv - Crain Towers (Other Name)
Practice location
1600 Crain Hwy S Ste 101Glen Burnie, MD 21061-6440
Phone 888-972-9700 · Fax 410-918-3425
Mailing address
10461 Mill Run Cir Ste 1020Owings Mills, MD 21117-5544
Phone 443-436-1221 · Fax 443-436-1256
Authorized official
David I Safferman
President & Ceo
4434361116
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