Healthcare Provider Details

I. General information

NPI: 1295001964
Provider Name (Legal Business Name): HADEEL NAQIB, M.D., P.A. F.A.A.P
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1232 RACE RD SUITE 201
BALTIMORE MD
21237-2351
US

IV. Provider business mailing address

1232 RACE RD SUITE 201
BALTIMORE MD
21237-2351
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-6434
  • Fax: 410-687-9855
Mailing address:
  • Phone: 410-687-6434
  • Fax: 410-687-9855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0041989
License Number StateMD

VIII. Authorized Official

Name: DR. HADEEL A NAQIB
Title or Position: OWNER
Credential: MD
Phone: 410-687-6434