Provider Demographics
NPI:1093907438
Name:VASCULAR IMAGING ASSOCIATES,LLC
Entity Type:Organization
Organization Name:VASCULAR IMAGING ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:K
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:202-368-9910
Mailing Address - Street 1:116 DEFENSE HWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7027
Mailing Address - Country:US
Mailing Address - Phone:202-368-9910
Mailing Address - Fax:
Practice Address - Street 1:10408 POOKEY WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-6043
Practice Address - Country:US
Practice Address - Phone:202-368-9910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR458752471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty