Basic Information
| Provider Information | |||||||||
| NPI: | 1174647416 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OZ | ||||||||
| FirstName: | RASIM | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2002 MEDICAL PKWY STE 235 | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102662770 | ||||||||
| FaxNumber: | 4108416251 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 MEDICAL PKWY | ||||||||
| Address2: | |||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102662770 | ||||||||
| FaxNumber: | 4108416251 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 07/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | D63391 | MD | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 412894000 | 05 | MD | MEDICAID | 418252 | 01 | PA | UPMC | OTHER | 1605144 | 01 | PA | GATEWAY | OTHER | 2695140 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 30113620 | 01 | PA | AMERIHEALTH MERCY - WMG | OTHER | 412894001 | 05 | MD | MEDICAID | 102691814 | 05 | PA | MEDICAID |