1013136886 NPI number — LUQMAN K DAD MD

Table of content: LUQMAN K DAD MD (NPI 1013136886)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013136886 NPI number — LUQMAN K DAD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAD
Provider First Name:
LUQMAN
Provider Middle Name:
K
Provider Name Prefix Text:
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:
1013136886
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 MEDICAL PKWY
Provider Second Line Business Mailing Address:
SUITE 235
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-3046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-266-2770
Provider Business Mailing Address Fax Number:
410-841-6251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 MEDICAL PKWY
Provider Second Line Business Practice Location Address:
SUITE 235
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-3046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-266-2770
Provider Business Practice Location Address Fax Number:
410-841-6251
Provider Enumeration Date:
04/24/2007

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: 2085R0001X , with the licence number:  D0072304 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: 319664 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1069-0035 . This is a "BLUE CHOICE GROUP HOSPITALIZATION & MEDICAL SERVICES" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: K606AN . This is a "CAREFIRST PROVIDER NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3221121 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 319664 . This is a "NY MEDICAL LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 8317071 . This is a "AETNA PPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 221568ZDYC . This is a "MEDICARE - BCF PA - PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 600576-03 . This is a "CAREFIRST OF MARYLAND - RENDERING NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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