Provider Demographics
NPI:1659198034
Name:ALLEGANY IMAGING, PC
Entity type:Organization
Organization Name:ALLEGANY IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-964-1035
Mailing Address - Street 1:PO BOX 3206
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21504-3206
Mailing Address - Country:US
Mailing Address - Phone:240-964-1035
Mailing Address - Fax:
Practice Address - Street 1:100 PIN OAK LN
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-5908
Practice Address - Country:US
Practice Address - Phone:240-964-1035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty