1366443152 NPI number — DR. AMR Z HEGAZI MD

Table of content: DR. AMR Z HEGAZI MD (NPI 1366443152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366443152 NPI number — DR. AMR Z HEGAZI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEGAZI
Provider First Name:
AMR
Provider Middle Name:
Z
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366443152
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
46B THOMAS JOHNSON DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
FREDERICK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21702-4300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-695-6777
Provider Business Mailing Address Fax Number:
301-695-4852

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
46B THOMAS JOHNSON DR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21702-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-695-6777
Provider Business Practice Location Address Fax Number:
301-695-4852
Provider Enumeration Date:
08/03/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  D44164 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0081294000 . This is a "WV. PROVIDER NPI" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 1366443152 . This is a "NPI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 452149 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9294621 . This is a "WV MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 112080800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3601046 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 5388078 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 01960002 . This is a "CAREFIRST FEDERAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 54749504 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3810012215 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 522074387 . This is a "TAX ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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