Healthcare Provider Details
I. General information
NPI: 1316169824
Provider Name (Legal Business Name): DRS GHARIB HIGGINS BROWN & RAZA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3001 S. HANOVER STREET
BALTIMORE MD
21225
US
IV. Provider business mailing address
1201 SEVEN LOCKS ROAD SUITE 200
ROCKVILLE MD
20854
US
V. Phone/Fax
- Phone: 410-350-3300
- Fax: 410-350-2033
- Phone: 301-652-5771
- Fax: 301-652-6332
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOHSEN
GHARIB
Title or Position: PRESIDENT
Credential: MD
Phone: 410-350-3300