Provider Demographics
NPI:1124003405
Name:WASHINGTON IMAGING ASSOCIATES OF DC, LLC
Entity Type:Organization
Organization Name:WASHINGTON IMAGING ASSOCIATES OF DC, LLC
Other - Org Name:FOXHALL MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STARR
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:703-667-8612
Mailing Address - Street 1:3201 JERMANTOWN RD STE 550
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2885
Mailing Address - Country:US
Mailing Address - Phone:703-667-8600
Mailing Address - Fax:703-667-8601
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:SUITE 106
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3622
Practice Address - Country:US
Practice Address - Phone:202-966-0606
Practice Address - Fax:202-244-6757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC645130Medicare PIN