NPI 1619437779 · live from the CMS NPI Registry
Matthew Dulles Bourne, DO
Radiology, Diagnostic Radiology in Silver Spring, MD. National Provider Identifier 1619437779, active.
NPI record
| NPI | 1619437779 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 1100 Wayne Ave Ste 1020, Silver Spring, MD 20910 |
| Practice phone | 703-390-9882 |
| Mailing address | 201 E University Pkwy Dept Of, Baltimore, MD 21218 |
| Enumerated | March 23, 2019 |
| Last updated | September 23, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology | 2085R0202X | DO-06857 (IA) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | H0100891 (MD) |
| Radiology, Diagnostic Radiology | 2085R0202X | 21575 (ND) |
| Radiology, Diagnostic Radiology | 2085R0202X | 2024039730 (MO) |
| Radiology, Diagnostic Radiology | 2085R0202X | DO-0133 (GU) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.