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 | 2085R0202X | Radiology | Diagnostic Radiology | D66722 | MARYLAND | 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 | 219037ZD7B | OTHER | MARYLAND | AAD GROUP PTAN |
| 2 | 38110091 | OTHER | MARYLAND | SHIPLEYS IMAGING |
| 3 | 219037DZYC | OTHER | MARYLAND | MEDICARE PIN - BCF GROUP |
| 4 | 219037ZEDL | OTHER | MARYLAND | AAD |
| 5 | 10730030 | OTHER | MARYLAND | AAD PROVIDER |
| 6 | 1069 | OTHER | MARYLAND | ARA - BCBS |
| 7 | CA1932 P01063488 | OTHER | MARYLAND | AAD RAILROAD PTAN |
| 8 | S645 60056008 | OTHER | MARYLAND | AAD CAREFIRST |
| 9 | 044204600 | MEDICAID | MARYLAND | |
| 10 | 10690036 | OTHER | MARYLAND | BLUE CHOICE |
| 11 | 219037ZCKL | OTHER | MARYLAND | SHIPLEYS GROUP PTAN |
| 12 | 044204600 | OTHER | MARYLAND | MEDICAL ASSISTANCE - SHIPLEYS |
| 13 | 044204600 | OTHER | MARYLAND | ARA MEDICAID |
| 14 | 9052710 | OTHER | MARYLAND | AETNA AAD SHIPLEYS |
| 15 | CK4885 P01055819 | OTHER | MARYLAND | BOWIE RAILROAD PTAN |
| 16 | K606AN | OTHER | MARYLAND | ARA - BCBS |
| 17 | KC46SH 60340002 | OTHER | MARYLAND | SHIPLEYS IMAGING CAREFIRST |