Organization
MARYLAND DIAGNOSTIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL COREN (PRESIDENT)
(215) 354-1260
Entity
Organization
Contact information
Practice address
101 W RIDGELY RD, 7B, TIMONIUM, MD 21093-5101
(410) 628-6046
Mailing address
853 SECOND STREET PIKE, B104, RICHBORO, PA 18954-1082
(215) 354-1260
(215) 354-1266
Taxonomy
Speciality
Code
Description
License number
State
246XC2903X
Vascular Specialist/Technologist Cardiovascular
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
2471S1302X
Sonography Radiologic Technologist
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111523
AETNA
MD
01
—
E509
CAREFIRST BLUECHOICE
MD
01
—
H444MA
CAREFIRST BC/BS
MD
Enumeration date
07/08/2005
Last updated
09/11/2025
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