1831414374 NPI number — DR. SHAHINE BAGHAI M.D.

Table of content: DR. SHAHINE BAGHAI M.D. (NPI 1831414374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831414374 NPI number — DR. SHAHINE BAGHAI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAGHAI
Provider First Name:
SHAHINE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1831414374
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4061 POWDER MILL RD
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
CALVERTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20705-3149
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-325-8515
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 S HANOVER ST
Provider Second Line Business Practice Location Address:
DEPT OF RADIOLOGY
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21225-1233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-350-3300
Provider Business Practice Location Address Fax Number:
410-350-2033
Provider Enumeration Date:
03/27/2010

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: 2085R0202X , with the licence number:  D74905 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0204X , with the licence number: D74905 , 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)