Organization
SHADY GROVE RADIOLOGICAL CONSULTANTS PA
Active
Other names
Shady Grove Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY W BUSCHING (CHIEF OPERATING OFFICER)
(301) 948-5700
Entity
Organization
Contact information
Practice address
20410 OBSERVATION DR, SUITE 104, GERMANTOWN, MD 20876-4000
(301) 948-5700
(301) 212-4277
Mailing address
20410 OBSERVATION DR, SUITE 104, GERMANTOWN, MD 20876-4000
(301) 948-5700
(301) 212-4277
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
—
—
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
979151500
—
MD
Enumeration date
05/18/2006
Last updated
08/25/2009
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