Organization
MAIDEN CHOICE NUCLEAR IMAGING CENTER
Active
Other names
St Agnes Nuclear Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
HOMAYOON MOGHBELI MD (PRESIDENT OF BOARD)
(410) 747-3300
Entity
Organization
Contact information
Practice address
724 MAIDEN CHOICE LN, SUITE 202, BALTIMORE, MD 21228-5911
(410) 747-3300
(410) 455-0009
Mailing address
724 MAIDEN CHOICE LN, SUITE 202, BALTIMORE, MD 21228-5911
(410) 747-3300
(410) 455-0009
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
MD0512101
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265080100
—
MD
Enumeration date
04/17/2006
Last updated
07/28/2009
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