Advanced Radiology P a
Organization Active NPI Diagnostic Radiology Physician · Hanover, MD
NPI 1033946231 · NPPES record last updated Sep 19, 2024
Key facts
- NPI
- 1033946231
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- ADVANCED RADIOLOGY P A
- Practice address
- 7556 Teague Rd Ste 200
Hanover, MD 21076-1389 - Phone
- (888) 972-9700
- Fax
- (410) 918-3425
- NPI assigned
- Sep 19, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- ADVANCED RADIOLOGY P A
Authorized official
- Name
- David I Safferman, M.D.
- Title
- President & Ceo
- Phone
- (443) 436-1116
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 14
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040420001334 | MD | Part B Supplier - Clinic/Group Practice | 1254327950 |
Receives reassigned benefits from 133 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Anant Kusakull
- Part of
- Anant Kusakull
Locations
7556 Teague Rd
Ste 200
Hanover, MD 21076
Phone (443) 729-8100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Physician |
207U00000X | |||
| Diagnostic Radiology Physician |
2085R0202X | Yes | ||
| Vascular & Interventional Radiology Physician |
2085R0204X |
Addresses
Primary practice location
7556 Teague Rd Ste 200
Hanover, MD 21076-1389
Mailing address
10461 Mill Run Cir Ste 1020
Owings Mills, MD 21117-5544
Phone (443) 436-1221
Other names
- ADV - Arundel Mills
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- Cynthia Chizoba Aguoru
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All providers in Hanover, MD · Diagnostic Radiology Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.