Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Dec 6, 2005
License(s)
D0037407 (MD), MD046969Y (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 10373A REISTERSTOWN RD | Owings Mills, MD 21117-3617 | 443-548-7595 |
| LOCATION | 8820 COLUMBIA 100 PKWY STE 100 | Columbia, MD 21045-2169 | 410-298-0454 |
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