MARTINSBURG RADIOLOGY ASSOC INC NPI 1922092568

NPI Information

NPI: 1922092568
Provider Name: MARTINSBURG RADIOLOGY ASSOC INC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
300 FOXCROFT AVE
SUITE 202B
MARTINSBURG, WV
ZIP 25401
Phone: (304) 263-4967
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MARTINSBURG RADIOLOGY ASSOC INC is a diagnostic radiology radiology in Martinsburg, WV. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MARTINSBURG RADIOLOGY ASSOC INC NPI is 1922092568. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

300 FOXCROFT AVE
SUITE 202B
MARTINSBURG, WV
ZIP 25401-341
Phone: (304) 263-4967
Fax: (304) 267-0974

The provider's authorized official is Dimitri Misailidis .
The authorized official title is President and has the following contact phone number (304) 263-4967.

The enumeration date for this NPI number is 9/9/2005 and was last updated on 3/25/2009.

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		WEST 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	134171500	MEDICAID	MARYLAND
2	9914653	MEDICARE ID-TYPE UNSPECIFIED	WEST VIRGINIA
3	0008749000	MEDICAID	WEST VIRGINIA
4	001709764	OTHER	WEST VIRGINIA	MT ST BCBS

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: 11/14/2023

NPI Synchronization or Removal

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