Provider Demographics
NPI:1679727291
Name:AMERICAN CARDIOVASCULAR IMAGING LLC
Entity type:Organization
Organization Name:AMERICAN CARDIOVASCULAR IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:P
Authorized Official - Last Name:KURIKESHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-931-1222
Mailing Address - Street 1:3270 ELEANORS GARDEN WAY
Mailing Address - Street 2:ALEXANDER P KURIKESHU MBR
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-7520
Mailing Address - Country:US
Mailing Address - Phone:301-931-1222
Mailing Address - Fax:301-931-1444
Practice Address - Street 1:11890 OLD BALTIMORE PIKE
Practice Address - Street 2:UNIT C
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1263
Practice Address - Country:US
Practice Address - Phone:301-931-1222
Practice Address - Fax:301-931-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No291U00000XLaboratoriesClinical Medical Laboratory