Healthcare Provider Details

I. General information

NPI: 1720271349
Provider Name (Legal Business Name): HADEEL NAQIB, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 05/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1232 RACE RD SUITE 201
BALTIMORE MD
21237-2351
US

IV. Provider business mailing address

1232 RACE RD SUITE 201
BALTIMORE MD
21237-2351
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-6434
  • Fax: 410-687-9855
Mailing address:
  • Phone: 410-687-6434
  • Fax: 410-687-9855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0041989
License Number StateMD

VIII. Authorized Official

Name: HADEEL I. NAQIB
Title or Position: OWNER
Credential: M.D.
Phone: 410-687-6434