1154647402 NPI number — ASGHAR SHAIGANY, MD LLC

Table of content: (NPI 1154647402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154647402 NPI number — ASGHAR SHAIGANY, MD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASGHAR SHAIGANY, MD LLC
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:
1154647402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5632 ANNAPOLIS RD
Provider Second Line Business Mailing Address:
SUITE 12
Provider Business Mailing Address City Name:
BLADENSBURG
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20710-2213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-864-3888
Provider Business Mailing Address Fax Number:
301-699-3007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5632 ANNAPOLIS RD
Provider Second Line Business Practice Location Address:
SUITE 12
Provider Business Practice Location Address City Name:
BLADENSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20710-2213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-864-3888
Provider Business Practice Location Address Fax Number:
301-699-3007
Provider Enumeration Date:
04/12/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SHAIGANY
Authorized Official First Name:
ASGHAR
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DOCTOR
Authorized Official Telephone Number:
301-864-3888

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD12938 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: B94178 , 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: 268751800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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