Provider Demographics
NPI:1639497308
Name:MAJORMEDICAL LLC PORTABLE DIAGNOSTICS
Entity Type:Organization
Organization Name:MAJORMEDICAL LLC PORTABLE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-585-1833
Mailing Address - Street 1:2129 CLARK PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1175
Mailing Address - Country:US
Mailing Address - Phone:301-585-1833
Mailing Address - Fax:240-235-3898
Practice Address - Street 1:8241 GEORGIA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4510
Practice Address - Country:US
Practice Address - Phone:301-585-1833
Practice Address - Fax:240-235-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064592207Q00000X, 2085U0001X
DCMD0360212085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty