1962484261 NPI number — DR. ASIF MOHAMED MD

Table of content: DR. ASIF MOHAMED MD (NPI 1962484261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962484261 NPI number — DR. ASIF MOHAMED MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOHAMED
Provider First Name:
ASIF
Provider Middle Name:
Provider Name Prefix Text:
DR.
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:
1962484261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/31/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3421 BENSON AVE
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21227-1056
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-368-1370
Provider Business Mailing Address Fax Number:
410-368-1382

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3421 BENSON AVE
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-368-1370
Provider Business Practice Location Address Fax Number:
410-368-1382
Provider Enumeration Date:
11/14/2005

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: 207RE0101X , with the licence number:  D0061387 , 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: 7015391 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64114701 . This is a "CARE FIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: J69000002 . This is a "BLUE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7322536 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3132403 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3502085 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 522442528 . This is a "UNITED H CARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com