1518148295 NPI number — HUMA SHAKIL, MD, PA

Table of content: (NPI 1326146598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518148295 NPI number — HUMA SHAKIL, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUMA SHAKIL, MD, PA
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:
6
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:
1518148295
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 KENT AVE, SUITE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUMBERLAND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21502-3799
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-777-7300
Provider Business Mailing Address Fax Number:
301-777-4000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
625 KENT AVE STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUMBERLAND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21502-3799
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-777-7300
Provider Business Practice Location Address Fax Number:
301-777-4000
Provider Enumeration Date:
11/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RAHMAN
Authorized Official First Name:
SHAKIL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
301-777-7300

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: FH56H . This is a "BCBS-NEW" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: R9110001 . This is a "FED BCSB & BLUE CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P18192 . This is a "BCBS POS-NEW" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 236826 . This is a "ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 836826 . This is a "MDIPA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 149631000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 53295001 . This is a "BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: M672 . This is a "BCBS-FED & BLUE CHOICE-NEW" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P11632 . This is a "BCBS POS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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