1700889755 NPI number — AZAR/FILIPOV MD PA

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:	AZAR/FILIPOV MD PA
Provider Last Name (Legal Name)	:
Provider First Name	:
Provider Middle Name	:
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Provider Name Suffix Text	:
Provider Credential Text	:
Provider Gender Code	:

Provider Other Organization Name	:
Provider Other Organization Name Type Code	:
Provider Other Last Name	:
Provider Other First Name	:
Provider Other Middle Name	:
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NPI Number	:	1700889755
Entity Type Code	:	Organization
Replacement NPI	:
Last Update Date	:	11/19/2009
NPI Deactivation Reason Code	:
NPI Deactivation Date	:
NPI Reactivation Date	:

Provider First Line Business Mailing Address	:	31519 WINTERPLACE PKWY
Provider Second Line Business Mailing Address	:	STE 1
Provider Business Mailing Address City Name	:	SALISBURY
Provider Business Mailing Address State Name	:	MD
Provider Business Mailing Address Postal Code	:	218041894
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	4105462500
Provider Business Mailing Address Fax Number	:	4105465005

Provider First Line Business Practice Location Address	:	31519 WINTERPLACE PKWY
Provider Second Line Business Practice Location Address	:	STE 1
Provider Business Practice Location Address City Name	:	SALISBURY
Provider Business Practice Location Address State Name	:	MD
Provider Business Practice Location Address Postal Code	:	218041894
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	4105462500
Provider Business Practice Location Address Fax Number	:	4105465005
Provider Enumeration Date	:	05/23/2005

Authorized Official Last Name	:	AZAR
Authorized Official First Name	:	ALEX
Authorized Official Middle Name	:
Authorized Official Title or Position	:	PRESIDENT
Authorized Official Telephone Number	:	4105462500

• Taxonomy code: 152W00000X .
• Taxonomy code: 207W00000X .

• Identifier: 063341100 , issued by the state of ( MD ) . This identifiers is of the category "".
• Identifier: G02090 , issued by the state of ( DE ) . This identifiers is of the category "".
• Identifier: CL6244 , issued by the state of ( MD ) . This identifiers is of the category "".
• Identifier: DD9992 , issued by the state of ( DE ) . This identifiers is of the category "".
• Identifier: 174L , issued by the state of ( MD ) . This identifiers is of the category "".