Healthcare Provider Details

I. General information

NPI: 1497692404
Provider Name (Legal Business Name): MUHAMMAD MANSOOR MOHIUDDIN MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S PINE ST
BALTIMORE MD
21201-1116
US

IV. Provider business mailing address

10 S PINE ST
BALTIMORE MD
21201-1116
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-6081
  • Fax: 410-706-0321
Mailing address:
  • Phone: 410-706-6081
  • Fax: 410-706-0321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License NumberNA
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: