Organization
RADIOLOGY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHIN J KORANGY MD (OWNER)
(703) 269-0704
Entity
Organization
Contact information
Practice address
12731 MARBLESTONE DR STE 105, WOODBRIDGE, VA 22192-8334
(703) 269-0704
Mailing address
12731 MARBLESTONE DR STE 105, WOODBRIDGE, VA 22192-8334
(703) 269-0704
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528627734
AETNA, CIGNA, UNITED, COMMERCIAL, MEDICAID VA, ANTHEM
VA
01
—
1770679466
NPI OF PROVIDER
VA
Enumeration date
06/11/2019
Last updated
12/30/2021
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