1396062915 NPI number — AMJAD M. RASUL, M.D., P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396062915 NPI number — AMJAD M. RASUL, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMJAD M. RASUL, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1396062915
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1160 VARNUM ST NE
Provider Second Line Business Mailing Address:
SUITE 114
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20017-2107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-526-8966
Provider Business Mailing Address Fax Number:
202-526-6025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1160 VARNUM ST NE
Provider Second Line Business Practice Location Address:
SUITE 114
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20017-2107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-526-8966
Provider Business Practice Location Address Fax Number:
202-526-6025
Provider Enumeration Date:
04/21/2010

Additional Information

Authorized Official

Authorized Official Last Name:
RASUL
Authorized Official First Name:
AMJAD
Authorized Official Middle Name:
MIAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
202-526-8966

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4088591 . This is a "AETNA USHC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 471514 . This is a "AETNA HMO/PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 41964101 . This is a "BCBS NATIONAL ACCT." identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 94760001 . This is a "BCBS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 024635600 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25272 . This is a "MDIPA/OPTIMUM CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 76900001 . This is a "BCBS MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3082912 . This is a "CIGNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1863236 . This is a "COVENTRY/FIRST HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2106613 . This is a "AETNA HMO/PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 110125682 . This is a "MEDICARE RR" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 357561600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 495350 . This is a "NCPPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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