Organization
NEUROSERVICE OF MARYLAND PC
Active
Organization
NEUROSERVICE OF MARYLAND PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS RALEY M.D. (PRESIDENT)
(240) 224-9504
Entity
Organization
Contact information
Practice address
325 ELLINGTON BLVD, PMB #454, GAITHERSBURG, MD 20878-4591
(240) 224-9504
Mailing address
325 ELLINGTON BLVD, PMB #454, GAITHERSBURG, MD 20878-4591
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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