MARSHALL C MINTZ MD NPI 1528086543

NPI Information

NPI: 1528086543
Provider Name: MARSHALL C MINTZ, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
2722 MERRILEE DR
SUITE 230
FAIRFAX, VA
ZIP 22031
Phone: (703) 698-4483
Get Directions

Marshall C Mintz, MD is a diagnostic radiology radiology in Fairfax, VA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Marshall C Mintz, MD NPI is 1528086543. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2722 MERRILEE DR
SUITE 230
FAIRFAX, VA
ZIP 22031-400
Phone: (703) 698-4483
Fax: (703) 573-0880

The NPI 1528086543 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 12/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	0101042585	VIRGINIA	No
2	2085N0700X	Radiology	Neuroradiology	0101042585	VIRGINIA	No
3	2085N0904X	Radiology	Nuclear Radiology	0101042585	VIRGINIA	No
4	2085P0229X	Radiology	Pediatric Radiology	0101042585	VIRGINIA	No
5	2085R0204X	Radiology	Vascular & Interventional Radiology	0101042585	VIRGINIA	No
6	2085U0001X	Radiology	Diagnostic Ultrasound	0101042585	VIRGINIA	No
7	2085R0202X	Radiology	Diagnostic Radiology	0101042585	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0022	OTHER	VIRGINIA	CAREFIRST BCBS
2	4211539	OTHER	VIRGINIA	AETNA PPO
3	C33261	MEDICARE UPIN	VIRGINIA
4	195764F43	MEDICARE PIN	DISTRICT OF COLUMBIA
5	300070107	MEDICARE PIN	VIRGINIA
6	300002542	MEDICARE PIN	VIRGINIA
7	2036276	OTHER	VIRGINIA	AETNA
8	101434	OTHER	VIRGINIA	KAISER PERMANENTE
9	301305	OTHER	VIRGINIA	AMERIGROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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