Med Tel International Corporation

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

M140C Issued in MD

Legal business name

MED TEL INTERNATIONAL CORPORATION

Doing business as

Wide Open MRI Imaging

Practice address

106 Milford St
Suite 602
Salisbury, MD 21804-6953

Phone

(410) 546-4300

Fax

(410) 860-1810

NPI assigned

Apr 27, 2006

Last updated

Jan 14, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

MED TEL INTERNATIONAL CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Valla

Title

Vice President

Phone

(973) 873-9850

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wide Open MRI Imaging Doing business as

Part of

Med-Tel Intrntl Corp

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Michael Blum, MD

  • Diagnostic Radiology Physician
  • Portland, OR
  • NPI 1861441560
  NPD (past)
• John Brennan Stockel, M.D.

  • Diagnostic Radiology Physician
  • Miami, FL
  • NPI 1609877067
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1275590903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 SPRING HILL RD",
            "address_2": "SUITE 500",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023000",
            "telephone_number": "703-287-4189",
            "fax_number": "703-448-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE 602",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-546-4300",
            "fax_number": "410-860-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED TEL INTERNATIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED TEL INTERNATIONAL CORPORATION",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "VALLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-873-9850"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "MD",
            "license": "M140C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17600100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wide Open MRI Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachael McWilliams, PHARM. D.
• John O Meadows, M.D.
• Stephen Lee Mears, NP
• Tyjanea Judah Mears, MA, CF-SLP
• Med Tel International Corporation (Wide Open Imaging)
• Chrystle Medina
• Medley's Healthcare Agency, LLC (Medley's Healthcare Agency)
• Medstar Health Weight Management, LLC
• Medstar Health Weight Management, LLC
• Medstar Health Weight Management, LLC

• Magnetic Resonance Imaging (MRI) Clinic/Center in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.