WESTERN MD PET IMAGING LLC NPI 1306849351

NPI Information

  • NPI: 1306849351
  • Provider Name: WESTERN MD PET IMAGING LLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 21D0939753
  • Address: 952 SETON DR
    CUMBERLAND, MD
    ZIP 21502
  • Phone: (301) 777-3522

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NPI Details

WESTERN MD PET IMAGING LLC is a specialist in Cumberland, MD. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. WESTERN MD PET IMAGING LLC NPI is 1306849351. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

952 SETON DR
CUMBERLAND, MD
ZIP 21502-950
Phone: (301) 777-3522
Fax: (301) 777-1902

The provider's authorized official is Jong K Kim .
The authorized official title is President and has the following contact phone number (301) 724-1646.

The CLIA number assigned to this NPI record is 21D0939753 - prison with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 7/25/2007.

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
1174400000XSpecialistYes

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
1217AOTHERMARYLANDMD BLUE SHIELD
2811MMEDICARE ID-TYPE UNSPECIFIEDMARYLAND
3J248OTHERMARYLANDMD BLUE SHIELD
4DB6053OTHERRAILROAD MEDICARE
50208472000MEDICAIDWEST VIRGINIA

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: 11/21/2025

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