Organization
UNIVERSITY OF MARYLAND DIAGNOSTIC RADIOLOGY, LLC
Active
Other names
AR-DRLLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES S WHITE MD (VICE PRESIDENT)
(410) 328-3477
Entity
Organization
Contact information
Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 787-4633
Mailing address
PO BOX 735782, DALLAS, TX 75373-5782
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
—
—
207UN0902X
Nuclear Imaging & Therapy Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302245501
—
MD
05
—
302245502
—
MD
05
—
302245503
—
MD
05
—
302245504
—
MD
Enumeration date
10/25/2019
Last updated
03/03/2021
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