| NPI | 1063886612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SCOTT DEHAVEN CEO 443-917-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: MD M478) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |