Provider Demographics
NPI:1780660217
Name:AMERICAN RADIOLOGY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:AMERICAN RADIOLOGY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-356-8186
Mailing Address - Street 1:10373A REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3617
Mailing Address - Country:US
Mailing Address - Phone:410-356-8186
Mailing Address - Fax:410-356-4180
Practice Address - Street 1:3700 FLEET ST STE 110
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4238
Practice Address - Country:US
Practice Address - Phone:443-681-3700
Practice Address - Fax:443-663-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDJ062OtherB/C B/S
MD785180400Medicaid
DC2849OtherB/C B/S
MDKA80OtherB/C B/S
DEG01120Medicare ID - Type UnspecifiedLOCALITY/JURIS. 02 DC/DE
DC2849OtherB/C B/S
MDCN2566Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MDUPINMedicare UPIN
MD785180400Medicaid
MDKA80OtherB/C B/S
MD434LMedicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 01