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Physicians Radiology Body Imaging

Provider NPI: 1639103849

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
2722 MERRILEE DR #230 FAIRFAX, VA 22031-4400 US
Tel: 703-698-4498  Fax: 703-573-0880

Business Mailing Address:
PO BOX 3650  MERRIFIELD, VA 22116-3650 US
Tel: 703-698-4498  Fax: 703-573-0880

NPI Information:
NPI: 1639103849
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Body Imaging

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2085R0202X





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