MEDICARE: FAISAL MOHAMMEDSALEH M KONBAZ MBBS

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1609278902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAISAL MOHAMMEDSALEH M KONBAZ MBBS

Provider Business Mailing Address
First Line	:	601 NORTH CAROLINE STREET JHOC 5215
Second Line	:	JOHNS HOPKINS DEPARTMENT OF ORTHOPAEDICS SURGERY
City	:	BALTIMORE
State	:	MD
Zip	:	21287-0882
Country	:	US
Telephone Number	:	410-955-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 NORTH CAROLINE STREET JHOC 5215
Second Line	:	JOHNS HOPKINS DEPARTMENT OF ORTHOPAEDICS SURGERY
City	:	BALTIMORE
State	:	MD
Zip	:	21287-0882
Country	:	US
Telephone Number	:	410-955-9300
Fax Number	:

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

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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