Provider Demographics
NPI:1366634107
Name:WASHINGTON IMAGING ASSOCIATES - MARYLAND LLC
Entity Type:Organization
Organization Name:WASHINGTON IMAGING ASSOCIATES - MARYLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:K
Authorized Official - Last Name:TU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-997-7000
Mailing Address - Street 1:7799 LEESBURG PIKE
Mailing Address - Street 2:SUITE 1008-N
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102
Mailing Address - Country:US
Mailing Address - Phone:703-442-4714
Mailing Address - Fax:703-442-4715
Practice Address - Street 1:3201 JERMANTOWN RD STE 550
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2885
Practice Address - Country:US
Practice Address - Phone:703-667-8600
Practice Address - Fax:703-667-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD174400000X
2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty