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Organization

LIGHTSPEED RADIOLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NOURREDDINE GUAO GUAOUGUAOU MD (PRESIDENT)
(703) 851-4310
Entity
Organization

Contact information

Practice address
9135 PISCATAWAY RD, CLINTON, MD 20735-2549
(419) 796-0306
Mailing address
PO BOX 54, MOUNT AIRY, MD 21771-0054

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0204X
Vascular & Interventional Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician

Other

Enumeration date
10/22/2014
Last updated
10/22/2014
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