Provider Demographics
NPI:1164808259
Name:PRECISION IMAGING AND DIAGNOSTIC SERVICES
Entity Type:Organization
Organization Name:PRECISION IMAGING AND DIAGNOSTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:I
Authorized Official - Last Name:ATUONWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-1607
Mailing Address - Street 1:3207 NEW COACH LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1218
Mailing Address - Country:US
Mailing Address - Phone:240-486-1607
Mailing Address - Fax:
Practice Address - Street 1:1807 PENNSYLVANIA AVE STE E
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3214
Practice Address - Country:US
Practice Address - Phone:240-486-1607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile