Midatlantic Diagnostic Imaging Centers LLC

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

Legal business name

MIDATLANTIC DIAGNOSTIC IMAGING CENTERS LLC

Practice address

3570 Saint Johns LN
Suite 104 B
Ellicott City, MD 21042-4020

Phone

(410) 480-0082

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

John Tucker

Title

President

Phone

(410) 480-0082

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ELICOTT OPEN MRI Doing business as

Locations

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1851457246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 SAINT JOHNS LN",
            "address_2": "SUITE 104 B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424020",
            "telephone_number": "410-480-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 SAINT JOHNS LN",
            "address_2": "SUITE 104 B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424020",
            "telephone_number": "410-480-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDATLANTIC DIAGNOSTIC IMAGING CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-480-0082"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "K676",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "970BEL",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELICOTT OPEN MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Meyering, PHD
• Emily Jean Meyers, FNP
• Onorine Mfondoh Bih
• Michael Mardiney, III, M.D. P.a.
• Michael R Mardiney Jr MD PA
• Sonia Kiran Midha, M.D.
• Andrew Milana
• Bertina Miles, OTR/L
• Renan Arpia Millama, PT
• Schade Millar, BS. SLPA

• Body Imaging Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Body Imaging Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.