Healthcare Provider Details

I. General information

NPI: 1770108375
Provider Name (Legal Business Name): ZOHA KARIM MOMIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W REDWOOD ST STE 235
BALTIMORE MD
21201-7031
US

IV. Provider business mailing address

419 W REDWOOD ST STE 235
BALTIMORE MD
21201-7031
US

V. Phone/Fax

Practice location:
  • Phone: 319-493-8285
  • Fax:
Mailing address:
  • Phone: 319-493-8285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberX0000
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberW1464
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: