MEDICARE: MRS. FOZIA QAYUM AHMED FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F09180178	MD
2	363LF0000X	Family Nurse Practitioner	R110960	MD

General Provider Information

NPI Number	:	1154804888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FOZIA QAYUM AHMED FNP-C

Provider Business Mailing Address
First Line	:	171- A RYAN RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-4541
Country	:	US
Telephone Number	:	410-360-6600
Fax Number	:	410-255-0450

Provider Business Practice Location Address
First Line	:	171- A RYAN RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-4541
Country	:	US
Telephone Number	:	410-360-6600
Fax Number	:	410-255-0450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	12/27/2023

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