Organization
MED TEL INTERNATIONAL CORPORATION
Active
Parent organization
MED TEL INTERNATIONAL CORPORATION
Other names
Wide Open MRI
Organization subpart
Yes
Provider details
NPI number
Legal business name
MED TEL INTERNATIONAL CORPORATION
Authorized official
JOHN VALLA (VICE PRESIDENT)
(973) 873-9850
Entity
Organization
Contact information
Practice address
684C POOLE RD, POOL ROAD MEDICAL CENTER, WESTMINSTER, MD 21157-6003
(410) 386-0835
(410) 386-0840
Mailing address
1430 SPRING HILL RD, SUITE 500, MCLEAN, VA 22102-3000
(703) 287-4189
(703) 448-1807
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
M209
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017600103
—
MD
Enumeration date
03/15/2007
Last updated
01/14/2008
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