Provider Demographics
NPI:1801029376
Name:KORANGY RADIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:KORANGY RADIOLOGY ASSOCIATES
Other - Org Name:BALTIMORE IMAGING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KORANGY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-764-0912
Mailing Address - Street 1:1777 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1306
Mailing Address - Country:US
Mailing Address - Phone:410-653-9993
Mailing Address - Fax:410-653-9934
Practice Address - Street 1:1777 REISTERSTOWN RD
Practice Address - Street 2:SUITE 14
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1306
Practice Address - Country:US
Practice Address - Phone:410-653-9993
Practice Address - Fax:410-653-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD460771600Medicaid
MD460771600Medicaid