Organization
PREMIER MRI SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER DUBIANSKY (CEO PRESIDENT)
(410) 267-1780
Entity
Organization
Contact information
Practice address
107 RIDGLEY AVE, SUITE 12, ANNAPOLIS, MD 21401
(410) 267-1780
(410) 267-1784
Mailing address
107 RIDGLEY AVE, SUITE 12, ANNAPOLIS, MD 21401
(410) 267-1780
(410) 267-1784
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
M231
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9398PR
BLUE SHIELD OF MARYLAND
MD
01
—
K646
BLUE SHIELD DC
DC
Enumeration date
09/06/2006
Last updated
04/25/2008
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