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

Table of content: (NPI 1396062915)

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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