Provider Demographics
NPI:1730104621
Name:BW IMAGING INC
Entity Type:Organization
Organization Name:BW IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:VINNITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-208-1423
Mailing Address - Street 1:11929 GLEN MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:301-208-1423
Mailing Address - Fax:301-208-1423
Practice Address - Street 1:114 SLADE AVE
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4906
Practice Address - Country:US
Practice Address - Phone:443-872-7052
Practice Address - Fax:410-400-6085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLS88OtherBC/BS
MD607520700Medicaid
MDLS88OtherBC/BS