Healthcare Provider Details

I. General information

NPI: 1689499485
Provider Name (Legal Business Name): AMINA ZAIDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEDICAL PKWY STE 101
ANNAPOLIS MD
21401-3743
US

IV. Provider business mailing address

12217 RUNNING FENCE LN
CLARKSVILLE MD
21029-1195
US

V. Phone/Fax

Practice location:
  • Phone: 410-268-8862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009684
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: