Organization
TYSONS CORNER DIAGNOSTIC IMAGING LLC
Active
Other names
Tysons Corner Diagnostic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE ELDER (CEO)
(678) 992-7255
Entity
Organization
Contact information
Practice address
8320 OLD COURTHOUSE RD STE 130, VIENNA, VA 22182-3848
(703) 356-4900
(703) 356-4602
Mailing address
3480 PRESTON RIDGE RD STE 600, ALPHARETTA, GA 30005-5462
(678) 992-7255
(678) 992-7455
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004991397
—
VA
01
—
470001480
MEDICARE RR
—
01
—
S372
CAREFIRST
—
Enumeration date
05/03/2006
Last updated
01/25/2026
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