Healthcare Provider Details

I. General information

NPI: 1063402170
Provider Name (Legal Business Name): KASHIF MUNIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 LINDEN AVE FLOOR 2 SOUTH
BALTIMORE MD
21201-4606
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 443-682-6800
  • Fax: 443-552-2991
Mailing address:
  • Phone: 410-328-8040
  • Fax: 443-462-3514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0059799
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: