Healthcare Provider Details

I. General information

NPI: 1053366013
Provider Name (Legal Business Name): MOHAMMED MARWAN ABUZAHRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 W BELVEDERE AVE SUITE 509
BALTIMORE MD
21215-5228
US

IV. Provider business mailing address

4000 OLD COURT RD STE 103
PIKESVILLE MD
21208-2828
US

V. Phone/Fax

Practice location:
  • Phone: 410-367-0100
  • Fax:
Mailing address:
  • Phone: 410-367-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM2523
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD67566
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberM2523
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: