Provider Demographics
NPI:1932269347
Name:PRINCE GEORGE'S OPEN MRI, LLC
Entity Type:Organization
Organization Name:PRINCE GEORGE'S OPEN MRI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-772-9545
Mailing Address - Street 1:8630 GUILFORD RD
Mailing Address - Street 2:SUITE 147
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2616
Mailing Address - Country:US
Mailing Address - Phone:301-772-9545
Mailing Address - Fax:301-772-0351
Practice Address - Street 1:1400 MERCANTILE LN
Practice Address - Street 2:SUITE 174
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5341
Practice Address - Country:US
Practice Address - Phone:301-772-9545
Practice Address - Fax:301-772-0351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)