Healthcare Provider Details

I. General information

NPI: 1003035676
Provider Name (Legal Business Name): ASMA S HANIF CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 LIBERTY HEIGHTS AVE
BALTIMORE MD
21207-7056
US

IV. Provider business mailing address

5115 LIBERTY HEIGHTS AVE
BALTIMORE MD
21207-7056
US

V. Phone/Fax

Practice location:
  • Phone: 410-466-8686
  • Fax:
Mailing address:
  • Phone: 410-466-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberR136864
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: